Provider Demographics
NPI:1003399353
Name:LITTLE FALLS PHYSICAL THERAPY CENTER LLC
Entity Type:Organization
Organization Name:LITTLE FALLS PHYSICAL THERAPY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:OMAR
Authorized Official - Last Name:GONZALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-856-0066
Mailing Address - Street 1:333 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07424-1267
Mailing Address - Country:US
Mailing Address - Phone:973-256-0066
Mailing Address - Fax:973-256-0059
Practice Address - Street 1:333 MAIN ST
Practice Address - Street 2:
Practice Address - City:LITTLE FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07424-1267
Practice Address - Country:US
Practice Address - Phone:973-256-0066
Practice Address - Fax:973-256-0059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-12
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation