Provider Demographics
NPI:1235350265
Name:FRANKLIN LAKES PHYSICAL THERAPY PC
Entity Type:Organization
Organization Name:FRANKLIN LAKES PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KATRIN
Authorized Official - Middle Name:L
Authorized Official - Last Name:RAMSEY
Authorized Official - Suffix:
Authorized Official - Credentials:DSC
Authorized Official - Phone:201-847-8585
Mailing Address - Street 1:795 FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07417-1368
Mailing Address - Country:US
Mailing Address - Phone:201-847-8585
Mailing Address - Fax:201-847-0985
Practice Address - Street 1:795 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:FRANKLIN LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07417-1368
Practice Address - Country:US
Practice Address - Phone:201-847-8585
Practice Address - Fax:201-847-0985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00336800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ184896OtherPTAN
NJ184896OtherPTAN