Provider Demographics
NPI:1215404926
Name:ELITE PHYSICAL THERAPY & WELLNESS
Entity Type:Organization
Organization Name:ELITE PHYSICAL THERAPY & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HIMANI
Authorized Official - Middle Name:N
Authorized Official - Last Name:HANI
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:267-250-5830
Mailing Address - Street 1:231 FIDDLERS ELBOW RD
Mailing Address - Street 2:
Mailing Address - City:PHILLIPSBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08865-9393
Mailing Address - Country:US
Mailing Address - Phone:267-250-5830
Mailing Address - Fax:972-662-7554
Practice Address - Street 1:988 MAIN AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07011-2478
Practice Address - Country:US
Practice Address - Phone:862-238-7735
Practice Address - Fax:862-238-7737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-31
Last Update Date:2018-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy