Provider Demographics
NPI:1326084138
Name:CHATHAM PHYSICAL THERAPY, P.A.
Entity Type:Organization
Organization Name:CHATHAM PHYSICAL THERAPY, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:BASKIN
Authorized Official - Last Name:SUSSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MA, PT
Authorized Official - Phone:973-635-6535
Mailing Address - Street 1:14B ROOSEVELT AVE
Mailing Address - Street 2:
Mailing Address - City:CHATHAM
Mailing Address - State:NJ
Mailing Address - Zip Code:07928-2552
Mailing Address - Country:US
Mailing Address - Phone:973-635-6535
Mailing Address - Fax:973-635-4099
Practice Address - Street 1:14B ROOSEVELT AVE
Practice Address - Street 2:
Practice Address - City:CHATHAM
Practice Address - State:NJ
Practice Address - Zip Code:07928-2552
Practice Address - Country:US
Practice Address - Phone:973-635-6535
Practice Address - Fax:973-635-4099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-21
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00389300225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty