Organization Active NPI

Core Dynamics Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Englewood, NJ
National Provider Identifier
1962684225
Registry record updated Oct 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
CORE DYNAMICS PHYSICAL THERAPY, LLC
Practice address
177 N Dean St
Suite 302
Englewood, NJ 07631-2533
Phone
(201) 568-5060
Fax
(201) 568-5061
NPI assigned
Nov 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2009

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

Authorized official

Name
Niva Ella Herzig, MS PTNPI 1265583637
Title
Owner/Manager
Phone
(201) 568-5060

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

177 N Dean St
Suite 302
Englewood, NJ 07631-2533

Mailing address

177 N Dean St
Suite 302
Englewood, NJ 07631-2533
Phone (201) 568-5060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071231000232 NJ Part B Supplier - Clinic/Group Practice 6103906342 Receives reassigned benefits from 2 practitioners
Practice locations: Englewood, NJ

National Provider Directory

National Provider Directory

Locations

177 N Dean St
Ste 302
Englewood, NJ 07631
Phone (201) 568-5060

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1196208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256688000000",
    "number": "1962684225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "177 N DEAN ST",
            "address_2": "SUITE 302",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076312533",
            "telephone_number": "201-568-5060",
            "fax_number": "201-568-5061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 N DEAN ST",
            "address_2": "SUITE 302",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076312533",
            "telephone_number": "201-568-5060",
            "fax_number": "201-568-5061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORE DYNAMICS PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-28",
        "last_updated": "2009-10-28",
        "status": "A",
        "authorized_official_last_name": "HERZIG",
        "authorized_official_first_name": "NIVA",
        "authorized_official_middle_name": "ELLA",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "201-568-5060",
        "authorized_official_credential": "MS PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2009; 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.