Professional Orthopedic and Sports Physical Therapy of N.J., LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PROFESSIONAL ORTHOPEDIC AND SPORTS PHYSICAL THERAPY OF N.J., LLC

Practice address

85 S Maple Ave
Ridgewood, NJ 07450-4561

Phone

(201) 857-5396

Fax

(201) 857-5398

NPI assigned

Feb 13, 2017

Organization subpart

No

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

Authorized official

Name

Kathleen Brush

Title

Credentialing Manager

Phone

(718) 819-6805

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1486944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486944000000",
    "number": "1982143806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2142 UTOPIA PKWY",
            "city": "WHITESTONE",
            "state": "NY",
            "postal_code": "113574142",
            "telephone_number": "718-819-6805",
            "fax_number": "347-841-9109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 S MAPLE AVE",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074504561",
            "telephone_number": "201-857-5396",
            "fax_number": "201-857-5398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL ORTHOPEDIC AND SPORTS PHYSICAL THERAPY OF N.J., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-13",
        "last_updated": "2017-02-13",
        "status": "A",
        "authorized_official_last_name": "BRUSH",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "718-819-6805"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Ridgewood, NJ
• Providers in Ridgewood, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 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.