Provider Demographics
NPI:1023547205
Name:PEAK HEALTH PHYSICAL THERAPY
Entity Type:Organization
Organization Name:PEAK HEALTH PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:TAWADROS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:201-647-3669
Mailing Address - Street 1:623 LAFAYETTE AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07506-2439
Mailing Address - Country:US
Mailing Address - Phone:201-647-3669
Mailing Address - Fax:201-212-6393
Practice Address - Street 1:50 ESSEX ST
Practice Address - Street 2:
Practice Address - City:ROCHELLE PARK
Practice Address - State:NJ
Practice Address - Zip Code:07662-4341
Practice Address - Country:US
Practice Address - Phone:201-647-3669
Practice Address - Fax:201-212-6393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-09
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01117600225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty