Provider Demographics
NPI:1285215897
Name:DOUBLE EAGLE PERFORMANCE, LLC.
Entity Type:Organization
Organization Name:DOUBLE EAGLE PERFORMANCE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:BONADONNA
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:646-675-7320
Mailing Address - Street 1:246 INDUSTRIAL WAY W
Mailing Address - Street 2:
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-4240
Mailing Address - Country:US
Mailing Address - Phone:732-706-8520
Mailing Address - Fax:732-800-5828
Practice Address - Street 1:246 INDUSTRIAL WAY W
Practice Address - Street 2:
Practice Address - City:EATONTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07724-4240
Practice Address - Country:US
Practice Address - Phone:732-706-8520
Practice Address - Fax:732-800-5828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-15
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty