Provider Demographics
NPI:1326155748
Name:SYNERGY PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:SYNERGY PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:FASS
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:908-852-5400
Mailing Address - Street 1:1885 STATE HIGHWAY 57
Mailing Address - Street 2:SUITE 5
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840
Mailing Address - Country:US
Mailing Address - Phone:908-852-5400
Mailing Address - Fax:908-852-5655
Practice Address - Street 1:1885 STATE HIGHWAY 57
Practice Address - Street 2:SUITE 5
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840
Practice Address - Country:US
Practice Address - Phone:908-852-5400
Practice Address - Fax:908-852-5655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00717500225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty