Provider Demographics
NPI:1093706814
Name:KARL MANSER, P.T., P.A.
Entity Type:Organization
Organization Name:KARL MANSER, P.T., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:KARL
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:MANSER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:201-569-2320
Mailing Address - Street 1:200 ENGLE ST
Mailing Address - Street 2:SUITE 17
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-2440
Mailing Address - Country:US
Mailing Address - Phone:201-569-2320
Mailing Address - Fax:201-569-2321
Practice Address - Street 1:200 ENGLE ST
Practice Address - Street 2:SUITE 17
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-2440
Practice Address - Country:US
Practice Address - Phone:201-569-2320
Practice Address - Fax:201-569-2321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00251000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2094975OtherAETNA PROVIDER ID
NJNJ4514OtherHEALTHNET PROVIDER ID
NJQ82921OtherEMPIRE BC PROVIDER ID
NJP1673774OtherOXFORD PROVIDER ID
NJ647147OtherUNITED HEALTHCARE ID
NJQ82921OtherEMPIRE BC PROVIDER ID