Provider Demographics
NPI:1063030898
Name:SANA SPINE AND PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:SANA SPINE AND PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEGHAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:WRONKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-906-1580
Mailing Address - Street 1:1719 ROUTE 10 STE 117
Mailing Address - Street 2:
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-4507
Mailing Address - Country:US
Mailing Address - Phone:201-906-1580
Mailing Address - Fax:
Practice Address - Street 1:1719 ROUTE 10 STE 117
Practice Address - Street 2:
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054-4507
Practice Address - Country:US
Practice Address - Phone:201-906-1580
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-08
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Single Specialty