Provider Demographics
NPI:1205003811
Name:EDINGER PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:EDINGER PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:E
Authorized Official - Last Name:EDINGER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:914-318-6093
Mailing Address - Street 1:273 LEONARDVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BELFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07718-1275
Mailing Address - Country:US
Mailing Address - Phone:914-318-6093
Mailing Address - Fax:
Practice Address - Street 1:273 LEONARDVILLE RD
Practice Address - Street 2:
Practice Address - City:BELFORD
Practice Address - State:NJ
Practice Address - Zip Code:07718-1275
Practice Address - Country:US
Practice Address - Phone:914-318-6093
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-13
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01165600225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty