Provider Demographics
NPI:1548340052
Name:RIDGEWOOD PHYSICAL THERAPY AND REHABILITATION CENTER INC.
Entity type:Organization
Organization Name:RIDGEWOOD PHYSICAL THERAPY AND REHABILITATION CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:E
Authorized Official - Last Name:MADISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-493-8111
Mailing Address - Street 1:104 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-2502
Mailing Address - Country:US
Mailing Address - Phone:201-493-8111
Mailing Address - Fax:201-493-8276
Practice Address - Street 1:104 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-2502
Practice Address - Country:US
Practice Address - Phone:201-493-8111
Practice Address - Fax:201-493-8276
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy