Provider Demographics
NPI:1164035713
Name:IVERZOS PHYSICAL THERAPY PC
Entity Type:Organization
Organization Name:IVERZOS PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:IRMINA
Authorized Official - Middle Name:
Authorized Official - Last Name:VERZOSA
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:917-957-1446
Mailing Address - Street 1:13 DARRELL CT
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08817-4702
Mailing Address - Country:US
Mailing Address - Phone:917-957-1446
Mailing Address - Fax:
Practice Address - Street 1:518 OLD POST RD STE 15
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08817-4683
Practice Address - Country:US
Practice Address - Phone:917-957-1446
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-24
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy