Provider Demographics
NPI:1174725980
Name:SANTA FE PHYSICAL THERAPY PC
Entity type:Organization
Organization Name:SANTA FE PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:P.T.M.A
Authorized Official - Prefix:
Authorized Official - First Name:ROSALBA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROJAS-CURRIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-617-0880
Mailing Address - Street 1:405 43RD ST
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07087-5047
Mailing Address - Country:US
Mailing Address - Phone:201-617-0880
Mailing Address - Fax:201-617-9735
Practice Address - Street 1:405 43RD ST
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:NJ
Practice Address - Zip Code:07087-5047
Practice Address - Country:US
Practice Address - Phone:201-617-0880
Practice Address - Fax:201-617-9735
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-04
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00154900261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ111736OtherMEDICARE ID