Provider Demographics
NPI:1366561672
Name:HARBOR PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:HARBOR PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:S
Authorized Official - Last Name:PALMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-346-3823
Mailing Address - Street 1:110 HARBOR LN
Mailing Address - Street 2:SUITE B
Mailing Address - City:SOMERS POINT
Mailing Address - State:NJ
Mailing Address - Zip Code:08244-2470
Mailing Address - Country:US
Mailing Address - Phone:609-653-9476
Mailing Address - Fax:609-653-9477
Practice Address - Street 1:110 HARBOR LN
Practice Address - Street 2:SUITE B
Practice Address - City:SOMERS POINT
Practice Address - State:NJ
Practice Address - Zip Code:08244-2470
Practice Address - Country:US
Practice Address - Phone:609-653-9476
Practice Address - Fax:609-653-9477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00699400225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1427190685OtherNATIONAL PROVIDER IDENTIF
$$$$$$$$$OtherSOCIAL SECURITY NUMBER