Provere Physical Therapy - Paramus LLC

Primary specialty

Sports Physical TherapistTaxonomy code 2251S0007X

Legal business name

PROVERE PHYSICAL THERAPY - PARAMUS LLC

Practice address

407 Sette Dr BLDG E
Paramus, NJ 07652-2940

Phone

(201) 538-7131

Fax

(201) 538-7131

NPI assigned

Jul 17, 2017

Organization subpart

No

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

Authorized official

Name

Cedric Haddad

Title

Co-Owner

Phone

(201) 538-7131

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1500249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1500249600000",
    "number": "1962925412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "637 WYCKOFF AVE PMB 361",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "074811438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 SETTE DR BLDG E",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076522940",
            "telephone_number": "201-538-7131",
            "fax_number": "201-538-7131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVERE PHYSICAL THERAPY - PARAMUS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-17",
        "last_updated": "2017-07-17",
        "status": "A",
        "authorized_official_last_name": "HADDAD",
        "authorized_official_first_name": "CEDRIC",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "201-538-7131"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Sports",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "NONE",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Sports Physical Therapist in Paramus, NJ
• Providers in Paramus, NJ by specialty
• Sports Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2017; 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.