Brunswick Physical Therapy and Rehabilitation LLC
Organization Active NPI Human Factors Physical Therapist · Edgewater, NJ
NPI 1780901330 · NPPES record last updated Apr 22, 2010
Key facts
- NPI
- 1780901330
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Human Factors Physical Therapist 2251H1300X
- License
- 40QA00520400 (NJ)
- Legal business name
- BRUNSWICK PHYSICAL THERAPY AND REHABILITATION LLC
- Practice address
- 725 River Rd
Suite 32-253
Edgewater, NJ 07020-1171 - Phone
- (201) 951-7534
- Fax
- (201) 758-5095
- NPI assigned
- Apr 22, 2010
- Organization subpart
- No
Authorized official
- Name
- Mr. Edilberto Orcullo Estomo Jr., PHYSICAL THERAPIST
- Title
- President
- Phone
- (201) 951-7534
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20141223001144 | NJ | Part B Supplier - Physical/Occupational Therapy Group in Private Practice | 3870816838 | Practice locations: Elizabeth, NJ; Middletown, NJ |
National Provider Directory
Locations
171 Elmora Ave
Fl 2
Elizabeth, NJ 07202
Phone (732) 255-5425
2446 Church Rd
Ste 2D
Toms River, NJ 08753
Phone (732) 244-6626
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Human Factors Physical Therapist |
2251H1300X | 40QA00520400 | NJ | Yes |
Addresses
Primary practice location
725 River Rd
Suite 32-253
Edgewater, NJ 07020-1171
Mailing address
725 River Rd
Suite 32-253
Edgewater, NJ 07020-1171
Phone (201) 951-7534
Other providers in Edgewater, NJ
- Boro of Edgewater
- Borough of Edgewater
- Anna Adeeb Botros
- Jbid L. Bozoglan
- Bridge to Wellness
- Marta M Bryceland
- Madelina Bucci
- Kathleen Cano Baamonde
- Care Medical New Jersey, P.C
- Leidys Casey
All providers in Edgewater, NJ · Human Factors Physical Therapist in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 22, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.