Oakland Spine and Physical Therapy of Wayne, LLC
Organization Active NPI Physical Therapist · Wayne, NJ
NPI 1861270548 · NPPES record last updated Sep 15, 2023
Key facts
- NPI
- 1861270548
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- Legal business name
- OAKLAND SPINE AND PHYSICAL THERAPY OF WAYNE, LLC
- Practice address
- 1255 Hamburg Tpke
Wayne, NJ 07470-5071 - Phone
- (201) 651-9100
- Fax
- (201) 651-1142
- NPI assigned
- Sep 15, 2023
- Organization subpart
- No
Authorized official
- Name
- Dr. Bradford Butler, DC
- Title
- Owner
- Phone
- (201) 651-9100
Corporate family (same tax ID) 1
Practitioners 10
-
David Jacques, PT, DPT
-
Roshan Joseph, D.C.
-
Jeffrey Wells, DC
-
Mark Steven Sielski, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240312002623 | NJ | Part B Supplier - Clinic/Group Practice | 0749626877 |
Receives reassigned benefits from 10 practitioners Practice locations: Wayne, NJ |
National Provider Directory
- Tax ID family
- Chiropractic Works of Wayne LLC
Locations
9 Post Rd
Ste M1
Oakland, NJ 07436
Phone (201) 337-9165
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | |||
| Acupuncturist |
171100000X | |||
| Physical Therapist |
225100000X | Yes |
Addresses
Primary practice location
1255 Hamburg Tpke
Wayne, NJ 07470-5071
Mailing address
9 Post Rd Ste M1
Oakland, NJ 07436-1615
Phone (201) 651-9100
Other providers in Wayne, NJ
- NV Medical Aesthetics
- Nwakanma Vivian Nwadike
- Laura O'Connor
- Eileen O'Sullivan
- Timothy O'Sullivan
- OB-GYN Affiliates of North Jersey LLC
- Marci Wolff Ober
- Mark Joseph Oberthaler
- Thomas M Obrotka
- Ogt Chiropractic Group, PA
All providers in Wayne, NJ · 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 Sep 15, 2023. 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.