Provider Demographics
NPI:1407188766
Name:FAMORCA, LUDOVIK (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MR
First Name:LUDOVIK
Middle Name:
Last Name:FAMORCA
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3511 ROBINSON CT
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-7014
Mailing Address - Country:US
Mailing Address - Phone:973-979-3870
Mailing Address - Fax:
Practice Address - Street 1:1621 ROUTE 22 WEST
Practice Address - Street 2:
Practice Address - City:BOUND BROOK
Practice Address - State:NJ
Practice Address - Zip Code:08805-1248
Practice Address - Country:US
Practice Address - Phone:732-469-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-11
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJPT40QA00950200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist