NPIMap

Organization Active NPI

Sports Medicine Center of Bergen, PA

  • Physical Therapist
  • Ramsey, NJ
National Provider Identifier
1992075352
Registry record updated Apr 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA00454300 Issued in NJ
Legal business name
SPORTS MEDICINE CENTER OF BERGEN, PA
Practice address
700C Lake St
Ramsey, NJ 07446-1372
Phone
(201) 962-7454
Fax
(201) 962-7455
NPI assigned
Jan 3, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2018

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

Authorized official

Name
Gary Flink, PT
Title
President/Owner
Phone
(201) 488-0488

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 40QA00454300 NJ Primary

Addresses

Primary practice location

700C Lake St
Ramsey, NJ 07446-1372

Mailing address

605 Main St
Hackensack, NJ 07601
Phone (201) 488-0488

Other names 1

  • TruCare Physical Therapy, PC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Excel Orthopedic Rehabi8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

700C Lake St
Ramsey, NJ 07446
Phone (201) 962-7454

NPI Registry JSON

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

{
    "created_epoch": "1325548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522713600000",
    "number": "1992075352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 MAIN ST",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "07601",
            "telephone_number": "201-488-0488",
            "fax_number": "201-343-5325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700C LAKE ST",
            "city": "RAMSEY",
            "state": "NJ",
            "postal_code": "074461372",
            "telephone_number": "201-962-7454",
            "fax_number": "201-962-7455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTS MEDICINE CENTER OF BERGEN, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-03",
        "last_updated": "2018-04-03",
        "status": "A",
        "authorized_official_last_name": "FLINK",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "201-488-0488",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00454300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TruCare Physical Therapy, PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ramsey, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2018; 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.