Provider Demographics
NPI:1316540115
Name:PHYSICAL THERAPY DOCTOR CARE PA
Entity Type:Organization
Organization Name:PHYSICAL THERAPY DOCTOR CARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:TSERLIN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:732-642-1784
Mailing Address - Street 1:406 OAK KNOLL DR
Mailing Address - Street 2:
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-3868
Mailing Address - Country:US
Mailing Address - Phone:732-642-1784
Mailing Address - Fax:
Practice Address - Street 1:406 OAK KNOLL DR
Practice Address - Street 2:
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-3868
Practice Address - Country:US
Practice Address - Phone:732-642-1784
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1573478Medicaid
NJ60146990Medicaid