Provider Demographics
NPI:1346437084
Name:ADVANTAGE ORTHOPAEDIC PHYSICAL THERAPY PA
Entity Type:Organization
Organization Name:ADVANTAGE ORTHOPAEDIC PHYSICAL THERAPY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-284-2444
Mailing Address - Street 1:1 STATE ROUTE 12
Mailing Address - Street 2:PLAZA ONE
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-7703
Mailing Address - Country:US
Mailing Address - Phone:908-284-2444
Mailing Address - Fax:908-284-2442
Practice Address - Street 1:1 STATE ROUTE 12
Practice Address - Street 2:PLAZA ONE
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-7703
Practice Address - Country:US
Practice Address - Phone:908-284-2444
Practice Address - Fax:908-284-2442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-26
Last Update Date:2012-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA003349002251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ091350Medicare PIN