Provider Demographics
NPI:1093285983
Name:SYNCHRONIZE PHYSICAL THERAPY, PC
Entity Type:Organization
Organization Name:SYNCHRONIZE PHYSICAL THERAPY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ARIELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUNKHORST
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:570-730-9840
Mailing Address - Street 1:183 BROAD ST APT 3
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-2695
Mailing Address - Country:US
Mailing Address - Phone:570-730-9840
Mailing Address - Fax:973-942-0523
Practice Address - Street 1:470 CHAMBERLAIN AVE STE 1
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07522-1000
Practice Address - Country:US
Practice Address - Phone:973-942-7451
Practice Address - Fax:973-942-0523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-04
Last Update Date:2018-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1174061402Medicaid