Provider Demographics
NPI:1043331515
Name:THE THERAPY CENTER OF CEDAR POINT
Entity Type:Organization
Organization Name:THE THERAPY CENTER OF CEDAR POINT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FNU
Authorized Official - Middle Name:
Authorized Official - Last Name:RITURAJ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-393-8828
Mailing Address - Street 1:702 CEDAR POINT BLVD
Mailing Address - Street 2:
Mailing Address - City:CEDAR POINT
Mailing Address - State:NC
Mailing Address - Zip Code:28584
Mailing Address - Country:US
Mailing Address - Phone:252-393-8828
Mailing Address - Fax:252-393-7928
Practice Address - Street 1:702 CEDAR POINT BLVD
Practice Address - Street 2:
Practice Address - City:CEDAR POINT
Practice Address - State:NC
Practice Address - Zip Code:28584
Practice Address - Country:US
Practice Address - Phone:252-393-8828
Practice Address - Fax:252-393-7928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2022-09-12
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
NC017F4OtherBLUE CROSS
NC7211966Medicaid
NC7211966Medicaid