Evolution Mom LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

EVOLUTION MOM LLC

Practice address

1465 Route 31 S
Annandale, NJ 08801-3129

Phone

(908) 797-1546

NPI assigned

Apr 30, 2024

Last updated

Apr 30, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lauren Mandell, PT, DPTNPI 1245581750

Title

Owner

Phone

(908) 797-1546

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lauren Mandell, DPT

  • Physical Therapist
  • Clark, NJ
  • NPI 1245581750
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1714435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714435200000",
    "number": "1689420531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 COLONIAL CT",
            "city": "LEBANON",
            "state": "NJ",
            "postal_code": "088334100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1465 ROUTE 31 S",
            "city": "ANNANDALE",
            "state": "NJ",
            "postal_code": "088013129",
            "telephone_number": "908-797-1546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLUTION MOM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-30",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A",
        "authorized_official_last_name": "MANDELL",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "908-797-1546",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Charles Curreri Jr., DPT
• Juliette D'Ambrosio, MS, LPC
• David V. Nenna, MD, PA
• Neyda Demarie, LMT, C-MLDT
• Michael T Eisenhart, PT
• Carson Ferris-Zeolla, DMD
• Flannery Physical Therapy Limited Partnership (Physical Therapy Plus (Annandale))
• Footcare Podiatry NJ PC
• Brian S Frese, OTR/L, CHT
• Garden State Dental Group LLC

• Physical Therapy Clinic/Center in Annandale, NJ
• Providers in Annandale, NJ by specialty
• Physical Therapy Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.