Physical Therapy Sports Rehab

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PHYSICAL THERAPY SPORTS REHAB

Practice address

585 Main St
Woodbridge, NJ 07095-1104

Phone

(732) 636-5151

Fax

(732) 602-0046

NPI assigned

Jan 10, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Mary Jo Bronson, PT

Title

Director of Physical Therapy

Phone

(732) 636-5151

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1780733212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "585 MAIN ST",
            "city": "WOODBRIDGE",
            "state": "NJ",
            "postal_code": "070951104",
            "telephone_number": "732-636-5151",
            "fax_number": "732-602-0046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585 MAIN ST",
            "city": "WOODBRIDGE",
            "state": "NJ",
            "postal_code": "070951104",
            "telephone_number": "732-636-5151",
            "fax_number": "732-602-0046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL THERAPY SPORTS REHAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BRONSON",
        "authorized_official_first_name": "MARY JO",
        "authorized_official_title_or_position": "DIRECTOR OF PHYSICAL THERAPY",
        "authorized_official_telephone_number": "732-636-5151",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "A495698",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ORTHONET EMPIRE BC",
            "identifier": "Q0W961",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA OPEN ACCESS PLUS",
            "identifier": "0120701",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "3K4352",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Perry Dental and TMJ Center, Inc
• Personalized Serenity Counseling Services
• Jennifer Megan Peterson, OD
• Brian Philipson, D.C.
• Lexis Phillips, DDS
• Francis Pierre
• Laurie Ann Pino, MOT
• John Pogoda, DMD
• Danielle Pompey-Plummer, LPC
• Nafisa Z. Poonawala, M.D.

• Physical Therapist in Woodbridge, NJ
• Providers in Woodbridge, 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 Jul 21, 2022; 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.