Optimal Form & Function, LLC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Legal business name

OPTIMAL FORM & FUNCTION, LLC

Practice address

1029 Teaneck Rd Ste 2E
Teaneck, NJ 07666-4514

Phone

(201) 887-2409

NPI assigned

Dec 16, 2024

Organization subpart

No

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

Authorized official

Name

Michael Formisano, DPTNPI 1902029242

Title

Owner

Phone

(201) 887-2409

Specialties & licenses 1

Addresses

Tax ID family

Optimal Form Function LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Optimal Form & Function, LLC

  • Physical Therapist
  • Teaneck, NJ
  • NPI 1194402180
  NPD tax ID

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Formisano, PT, DPT, OCS

  • Physical Therapist
  • Teaneck, NJ
  • NPI 1902029242
  NPD Authorized official
• Rina Tyszler-Mogul, OTR, CLT

  • Occupational Therapist
  • Westwood, NJ
  • NPI 1679708911
  NPD
• Dave Consunji Marcon, P.T.

  • Physical Therapist
  • Teaneck, NJ
  • NPI 1932301843
  NPD (past)

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

{
    "created_epoch": "1734307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734307200000",
    "number": "1790592517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3-18 VIRGINIA DR",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074104727",
            "telephone_number": "201-887-2409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1029 TEANECK RD STE 2E",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076664514",
            "telephone_number": "201-887-2409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMAL FORM & FUNCTION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-16",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-15",
        "status": "A",
        "authorized_official_last_name": "FORMISANO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-887-2409",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linneah Olsen
• Elizabeth Danielle Olson, PA
• Michellin Ona
• One Acupuncture & Herbs, PC
• Optimal Form & Function, LLC
• Lilian Orellana
• Oscar Orengo Jr., ATC
• Deborah Orlan-Marcus, M.S.
• Jessica Orlinsky
• Genara O Ortiz

• Occupational Therapist in Teaneck, NJ
• Providers in Teaneck, NJ by specialty
• Occupational Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 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.