Provider Demographics
NPI:1093736233
Name:BIMODAL PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:BIMODAL PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:INESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMMERSHMIDT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-943-5200
Mailing Address - Street 1:725 RIVER RD
Mailing Address - Street 2:STE 107B
Mailing Address - City:EDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:07020-1171
Mailing Address - Country:US
Mailing Address - Phone:201-943-5200
Mailing Address - Fax:201-943-1997
Practice Address - Street 1:725 RIVER RD
Practice Address - Street 2:STE 107B
Practice Address - City:EDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:07020-1171
Practice Address - Country:US
Practice Address - Phone:201-943-5200
Practice Address - Fax:201-943-1997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2013-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
081218Medicare ID - Type Unspecified