Provider Demographics
NPI:1164401220
Name:WINDSOR PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:WINDSOR PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:L
Authorized Official - Last Name:CHAWNER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:609-660-1980
Mailing Address - Street 1:2 FOREST EDGE CT
Mailing Address - Street 2:
Mailing Address - City:MANAHAWKIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08050-7806
Mailing Address - Country:US
Mailing Address - Phone:609-660-1980
Mailing Address - Fax:609-660-1980
Practice Address - Street 1:2 FOREST EDGE CT
Practice Address - Street 2:
Practice Address - City:MANAHAWKIN
Practice Address - State:NJ
Practice Address - Zip Code:08050-7806
Practice Address - Country:US
Practice Address - Phone:609-660-1980
Practice Address - Fax:609-660-1980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-17
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01040600225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ099245Medicare PIN