NPIMap

Organization Active NPI

Dynamic Care Physical Therapy, Inc.

  • Physical Therapist
  • North Bergen, NJ
National Provider Identifier
1902111214
Registry record updated Aug 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA00766400 Issued in NJ
Legal business name
DYNAMIC CARE PHYSICAL THERAPY, INC.
Practice address
1625 Kennedy Blvd
North Bergen, NJ 07047-6302
Phone
(201) 558-0808
Fax
(201) 558-0877
NPI assigned
Aug 11, 2010
Last updated
Aug 11, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2010

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

Authorized official

Name
Warren Borres, PTNPI 1467590026
Title
President
Phone
(201) 558-0808

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA00766400 NJ Primary

Addresses

Primary practice location

1625 Kennedy Blvd
North Bergen, NJ 07047-6302

Mailing address

43 Greyhound CT
Kendall Park, NJ 08824-1492
Phone (201) 558-0808

Other identifiers 2

IdentifierTypeStateIssuer
40QA00766400OtherNJNEW JERSEY PHYSICAL THERAPY LICENSE NUMBER
066705OtherNJMEDICARE PROVIDER NUMBER (INDIVIDUAL)

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1281484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281484800000",
    "number": "1902111214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 GREYHOUND CT",
            "city": "KENDALL PARK",
            "state": "NJ",
            "postal_code": "088241492",
            "telephone_number": "201-558-0808",
            "fax_number": "201-558-0877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 KENNEDY BLVD",
            "city": "NORTH BERGEN",
            "state": "NJ",
            "postal_code": "070476302",
            "telephone_number": "201-558-0808",
            "fax_number": "201-558-0877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC CARE PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-11",
        "last_updated": "2010-08-11",
        "status": "A",
        "authorized_official_last_name": "BORRES",
        "authorized_official_first_name": "WARREN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-558-0808",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00766400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW JERSEY PHYSICAL THERAPY LICENSE NUMBER",
            "identifier": "40QA00766400",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER NUMBER (INDIVIDUAL)",
            "identifier": "066705",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Bergen, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2010; 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.