Provider Demographics
NPI:1316014244
Name:FAMILY FOCUS PHYSICAL THERAPY PA
Entity Type:Organization
Organization Name:FAMILY FOCUS PHYSICAL THERAPY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:A
Authorized Official - Last Name:MINNIS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:732-681-1122
Mailing Address - Street 1:PO BOX 1703
Mailing Address - Street 2:
Mailing Address - City:WALL
Mailing Address - State:NJ
Mailing Address - Zip Code:07719
Mailing Address - Country:US
Mailing Address - Phone:732-681-1122
Mailing Address - Fax:732-681-0999
Practice Address - Street 1:2510 BELMAR BLVD
Practice Address - Street 2:J1 J2
Practice Address - City:WALL
Practice Address - State:NJ
Practice Address - Zip Code:07719
Practice Address - Country:US
Practice Address - Phone:732-681-1122
Practice Address - Fax:732-681-0999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ805936Medicare ID - Type Unspecified