Provider Demographics
NPI:1770548257
Name:PHYSICAL THERAPY CENTER OF TEANECK PA
Entity type:Organization
Organization Name:PHYSICAL THERAPY CENTER OF TEANECK PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:NAFPLIOTIS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD PT
Authorized Official - Phone:201-837-0337
Mailing Address - Street 1:194 THE PLAZA
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-5157
Mailing Address - Country:US
Mailing Address - Phone:201-837-0337
Mailing Address - Fax:201-833-0338
Practice Address - Street 1:194 THE PLAZA
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-5157
Practice Address - Country:US
Practice Address - Phone:201-837-0337
Practice Address - Fax:201-833-0338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-19
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJQA00632261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ=========OtherTIN
NJ316516Medicare ID - Type UnspecifiedMEDICARE PROVIDER ID