Provider Demographics
NPI:1215206669
Name:FAIRFIELD WELLNESS AND PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:FAIRFIELD WELLNESS AND PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCLAUGHLIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:973-403-9911
Mailing Address - Street 1:25 GREENBROOK RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07004-3890
Mailing Address - Country:US
Mailing Address - Phone:973-403-9911
Mailing Address - Fax:973-403-9912
Practice Address - Street 1:25 GREENBROOK RD
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07004-3890
Practice Address - Country:US
Practice Address - Phone:973-403-9911
Practice Address - Fax:973-403-9912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-14
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00643100111N00000X
NJPT40QA01022800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty