Provider Demographics
NPI:1235332156
Name:APEX ORTHOPEDIC REHABILITATION INC.
Entity Type:Organization
Organization Name:APEX ORTHOPEDIC REHABILITATION INC.
Other - Org Name:APEX ORTHOPEDIC REHABILITATION INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PYHSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:TOM
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:WILLEMANN
Authorized Official - Suffix:
Authorized Official - Credentials:PT,MS,OCS
Authorized Official - Phone:201-251-2422
Mailing Address - Street 1:1 E RIDGEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-3629
Mailing Address - Country:US
Mailing Address - Phone:201-251-2422
Mailing Address - Fax:201-251-7869
Practice Address - Street 1:1 E RIDGEWOOD AVE
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-3629
Practice Address - Country:US
Practice Address - Phone:201-251-2422
Practice Address - Fax:201-251-7869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJQA 007709174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ=========Other039725 NJ
NJ=========Other039725 NJ