New Jersey Luna Care Physical Therapy, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

NEW JERSEY LUNA CARE PHYSICAL THERAPY, LLC

Practice address

2 University PLZ Ste 100
Hackensack, NJ 07601-6210

Phone

(877) 839-6979

Fax

(833) 817-7128

NPI assigned

Apr 27, 2020

Last updated

Jan 5, 2023By 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

Clarisa Odell

Title

Manager

Phone

(866) 806-3599

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1587945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672876800000",
    "number": "1952922304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2350",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "956778350",
            "telephone_number": "866-806-3599",
            "fax_number": "833-817-7128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 UNIVERSITY PLZ STE 100",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076016210",
            "telephone_number": "877-839-6979",
            "fax_number": "833-817-7128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW JERSEY LUNA CARE PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-27",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A",
        "authorized_official_last_name": "ODELL",
        "authorized_official_first_name": "CLARISA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "866-806-3599"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2023; 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.