Provider Demographics
NPI:1033140819
Name:ACTION PHYSICAL THERAPY & SPORTS REHABILITATION INC
Entity Type:Organization
Organization Name:ACTION PHYSICAL THERAPY & SPORTS REHABILITATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:
Authorized Official - Last Name:PIERRO
Authorized Official - Suffix:JR
Authorized Official - Credentials:PT
Authorized Official - Phone:973-956-7807
Mailing Address - Street 1:79 UNION BLVD
Mailing Address - Street 2:
Mailing Address - City:TOTOWA
Mailing Address - State:NJ
Mailing Address - Zip Code:07512-2739
Mailing Address - Country:US
Mailing Address - Phone:973-956-7807
Mailing Address - Fax:973-956-7808
Practice Address - Street 1:79 UNION BLVD
Practice Address - Street 2:
Practice Address - City:TOTOWA
Practice Address - State:NJ
Practice Address - Zip Code:07512-2739
Practice Address - Country:US
Practice Address - Phone:973-956-7807
Practice Address - Fax:973-956-7808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2013-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ=========OtherTAX ID NUMBER