Provider Demographics
NPI:1073213476
Name:SP PHYSICAL THERAPY WELLNESS, P.C.
Entity Type:Organization
Organization Name:SP PHYSICAL THERAPY WELLNESS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST / CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SAGAR
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-377-8092
Mailing Address - Street 1:139 FULTON STREET, SUITE # 208
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10038-2538
Mailing Address - Country:US
Mailing Address - Phone:201-377-8092
Mailing Address - Fax:845-595-8220
Practice Address - Street 1:139 FULTON STREET, SUITE # 208
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-2538
Practice Address - Country:US
Practice Address - Phone:201-377-8092
Practice Address - Fax:845-595-8220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy