Active Recovery Physical Rehabilitation and Wellness

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA07859 Issued in NJ

Legal business name

ACTIVE RECOVERY PHYSICAL REHABILITATION AND WELLNESS

Practice address

22 Carnation St
Bergenfield, NJ 07621-3802

Phone

(201) 661-0911

NPI assigned

Sep 11, 2012

Organization subpart

No

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

Authorized official

Name

Sherwin R. Santos, PT

Title

Director

Phone

(201) 661-0911

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1347321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347321600000",
    "number": "1992055586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 CARNATION ST",
            "city": "BERGENFIELD",
            "state": "NJ",
            "postal_code": "076213802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 CARNATION ST",
            "city": "BERGENFIELD",
            "state": "NJ",
            "postal_code": "076213802",
            "telephone_number": "201-661-0911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE RECOVERY PHYSICAL REHABILITATION AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-11",
        "last_updated": "2012-09-11",
        "status": "A",
        "authorized_official_last_name": "SANTOS",
        "authorized_official_first_name": "SHERWIN",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "201-661-0911",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA07859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Bergenfield, NJ
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2012; 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.