Provider Demographics
NPI:1942970009
Name:THOMAS BERG, DPT LLC
Entity type:Organization
Organization Name:THOMAS BERG, DPT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:BERG
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:908-917-6920
Mailing Address - Street 1:22 ARDMORE RD
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-7842
Mailing Address - Country:US
Mailing Address - Phone:908-917-6920
Mailing Address - Fax:
Practice Address - Street 1:2907 US HIGHWAY 9
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:NJ
Practice Address - Zip Code:07731-3745
Practice Address - Country:US
Practice Address - Phone:732-416-4617
Practice Address - Fax:732-303-8520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-20
Last Update Date:2021-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy