Provider Demographics
NPI:1093489452
Name:HEALING HANDS ON PHYSICAL THERAPY PC
Entity Type:Organization
Organization Name:HEALING HANDS ON PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF PHYSICAL THERAPY
Authorized Official - Prefix:MR
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:ROQUE
Authorized Official - Last Name:MENDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DPT, SCS
Authorized Official - Phone:973-870-2272
Mailing Address - Street 1:77 NEWARK AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07109-4154
Mailing Address - Country:US
Mailing Address - Phone:201-277-4361
Mailing Address - Fax:848-238-2009
Practice Address - Street 1:77 NEWARK AVE STE 3
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07109-4154
Practice Address - Country:US
Practice Address - Phone:201-277-4361
Practice Address - Fax:848-238-2009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-08
Last Update Date:2021-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSportsGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty