Provider Demographics
NPI:1316002868
Name:PHYSICAL THERAPY ASSOCIATES OF MERCER COUNTY, INC.
Entity Type:Organization
Organization Name:PHYSICAL THERAPY ASSOCIATES OF MERCER COUNTY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:A
Authorized Official - Last Name:WOLFINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-586-3322
Mailing Address - Street 1:2273 HIGHWAY 33
Mailing Address - Street 2:SUITE 202
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08690-1747
Mailing Address - Country:US
Mailing Address - Phone:609-586-3322
Mailing Address - Fax:609-586-9094
Practice Address - Street 1:2273 HIGHWAY 33
Practice Address - Street 2:SUITE 202
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08690-1747
Practice Address - Country:US
Practice Address - Phone:609-586-3322
Practice Address - Fax:609-586-9094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2008-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00243500225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ630241Medicare PIN