Provider Demographics
NPI:1194822452
Name:NEWARK PHYSICAL THERAPY & SPORTS INJURY REHABILITATION, PC
Entity Type:Organization
Organization Name:NEWARK PHYSICAL THERAPY & SPORTS INJURY REHABILITATION, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:WEMETT
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:315-331-3784
Mailing Address - Street 1:513 W UNION ST
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NY
Mailing Address - Zip Code:14513-1365
Mailing Address - Country:US
Mailing Address - Phone:315-331-3784
Mailing Address - Fax:315-331-4667
Practice Address - Street 1:513 W UNION ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NY
Practice Address - Zip Code:14513-1365
Practice Address - Country:US
Practice Address - Phone:315-331-3784
Practice Address - Fax:315-331-4667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty