Provider Demographics
NPI:1285220871
Name:NDS PHYSICAL THERAPY P.C.
Entity Type:Organization
Organization Name:NDS PHYSICAL THERAPY P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:NOLAN
Authorized Official - Middle Name:FROYD
Authorized Official - Last Name:DE SESTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-902-1964
Mailing Address - Street 1:321 TEXAS DR
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-6030
Mailing Address - Country:US
Mailing Address - Phone:908-902-1964
Mailing Address - Fax:
Practice Address - Street 1:835 60TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-4310
Practice Address - Country:US
Practice Address - Phone:908-902-1964
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-17
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy