Provider Demographics
NPI:1134463235
Name:THERAPHYSICAL, LLC
Entity Type:Organization
Organization Name:THERAPHYSICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DPT
Authorized Official - Prefix:DR
Authorized Official - First Name:MAGDALENA
Authorized Official - Middle Name:
Authorized Official - Last Name:BUCZEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-340-4656
Mailing Address - Street 1:623 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07071-3205
Mailing Address - Country:US
Mailing Address - Phone:201-340-4656
Mailing Address - Fax:201-340-4580
Practice Address - Street 1:623 RIDGE RD
Practice Address - Street 2:
Practice Address - City:LYNDHURST
Practice Address - State:NJ
Practice Address - Zip Code:07071-3205
Practice Address - Country:US
Practice Address - Phone:201-340-4656
Practice Address - Fax:201-340-4580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-15
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01383800261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy