St. Mina Therapeutics LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

ST. MINA THERAPEUTICS LLC

Practice address

418 Smith St
Perth Amboy, NJ 08861-3829

Phone

(732) 641-3620

Fax

(732) 826-3613

NPI assigned

Dec 4, 2014

Organization subpart

No

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

Authorized official

Name

Ms. Mina Massak, PT

Title

Owner

Phone

(732) 641-3620

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1417651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417651200000",
    "number": "1700283884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 521",
            "city": "PERTH AMBOY",
            "state": "NJ",
            "postal_code": "088620521",
            "telephone_number": "732-641-3620",
            "fax_number": "732-826-3613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 SMITH ST",
            "city": "PERTH AMBOY",
            "state": "NJ",
            "postal_code": "088613829",
            "telephone_number": "732-641-3620",
            "fax_number": "732-826-3613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. MINA THERAPEUTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-04",
        "last_updated": "2014-12-04",
        "status": "A",
        "authorized_official_last_name": "MASSAK",
        "authorized_official_first_name": "MINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-641-3620",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NJ HEALTH",
            "identifier": "60099622",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Perth Amboy, NJ
• Providers in Perth Amboy, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2014; 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.