Provider Demographics
NPI:1174621874
Name:PHYSICAL THERAPY UNLIMITED PA
Entity type:Organization
Organization Name:PHYSICAL THERAPY UNLIMITED PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:CARHART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-756-8898
Mailing Address - Street 1:23 MOUNTAIN BLVD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:NJ
Mailing Address - Zip Code:07059
Mailing Address - Country:US
Mailing Address - Phone:908-756-8898
Mailing Address - Fax:908-756-8899
Practice Address - Street 1:23 MOUNTAIN BLVD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:NJ
Practice Address - Zip Code:07059
Practice Address - Country:US
Practice Address - Phone:908-756-8898
Practice Address - Fax:908-756-8899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00572900225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
552313OtherAETNA
8379444OtherCIGNA
31001OtherCIGNA ORTHONET
8802823OtherGHI
OK7519OtherACS/HEALTHNET
TS152OtherOXFORD
NJ815670Medicare ID - Type Unspecified