Provider Demographics
NPI:1750097713
Name:GOLD STANDARD PHYSICAL THERAPY NYNJ, LLC
Entity type:Organization
Organization Name:GOLD STANDARD PHYSICAL THERAPY NYNJ, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SANDI
Authorized Official - Middle Name:MICHELE
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:917-747-0977
Mailing Address - Street 1:60 IVANHOE DRIVE
Mailing Address - Street 2:
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726
Mailing Address - Country:US
Mailing Address - Phone:212-481-4022
Mailing Address - Fax:212-481-4023
Practice Address - Street 1:8 W 36TH ST FL 6
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-9775
Practice Address - Country:US
Practice Address - Phone:929-777-3883
Practice Address - Fax:929-488-1224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-24
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty