Provider Demographics
NPI:1033882345
Name:PT ON THE GO PC
Entity Type:Organization
Organization Name:PT ON THE GO PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:GINDI
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, EMT
Authorized Official - Phone:732-660-5422
Mailing Address - Street 1:11 ELINORE AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BRANCH
Mailing Address - State:NJ
Mailing Address - Zip Code:07740-4824
Mailing Address - Country:US
Mailing Address - Phone:732-660-5422
Mailing Address - Fax:
Practice Address - Street 1:11 ELINORE AVE
Practice Address - Street 2:
Practice Address - City:LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07740-4824
Practice Address - Country:US
Practice Address - Phone:732-660-5422
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-01
Last Update Date:2021-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty