Provider Demographics
NPI:1093800922
Name:ALLWOOD PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:ALLWOOD PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ROMMER
Authorized Official - Last Name:IGNACIO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:973-616-7117
Mailing Address - Street 1:925 CLIFTON AVE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-2724
Mailing Address - Country:US
Mailing Address - Phone:973-616-7117
Mailing Address - Fax:973-616-7338
Practice Address - Street 1:925 CLIFTON AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-2724
Practice Address - Country:US
Practice Address - Phone:973-616-7117
Practice Address - Fax:973-616-7338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01051300225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ067985RSTMedicare ID - Type UnspecifiedROMMER'S INDIVIDUAL NUMBE
NJ070047Medicare ID - Type UnspecifiedGROUP NUMBER
NJ057843RSTMedicare ID - Type UnspecifiedROY'S INDIVIDUAL NUMBER