Brunswick Physical Therapy and Rehabilitation LLC

Primary specialty

Human Factors Physical TherapistTaxonomy code 2251H1300X

License

40QA00520400 Issued in 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

Last updated

Apr 22, 2010By 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

Mr. Edilberto Orcullo Estomo Jr., PHYSICAL THERAPIST

Title

President

Phone

(201) 951-7534

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

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

{
    "created_epoch": "1271894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271894400000",
    "number": "1780901330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 RIVER RD",
            "address_2": "SUITE 32-253",
            "city": "EDGEWATER",
            "state": "NJ",
            "postal_code": "070201171",
            "telephone_number": "201-951-7534",
            "fax_number": "201-758-5095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 RIVER RD",
            "address_2": "SUITE 32-253",
            "city": "EDGEWATER",
            "state": "NJ",
            "postal_code": "070201171",
            "telephone_number": "201-951-7534",
            "fax_number": "201-758-5095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUNSWICK PHYSICAL THERAPY AND REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-22",
        "last_updated": "2010-04-22",
        "status": "A",
        "authorized_official_last_name": "ESTOMO",
        "authorized_official_first_name": "EDILBERTO",
        "authorized_official_middle_name": "ORCULLO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-951-7534",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "PHYSICAL THERAPIST"
    },
    "taxonomies": [
        {
            "code": "2251H1300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Human Factors",
            "state": "NJ",
            "license": "40QA00520400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Boro of Edgewater
• Borough of Edgewater
• Anna Adeeb Botros, PT
• Jbid L. Bozoglan, LCSW
• Bridge to Wellness
• Marta M Bryceland, AGNP-BC
• Madelina Bucci
• Kathleen Cano Baamonde
• Care Medical New Jersey, P.C
• Leidys Casey

• Physical Therapist in Edgewater, NJ
• Providers in Edgewater, 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 Apr 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.