Provider Demographics
NPI:1447796685
Name:OPT-2-HEAL PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:OPT-2-HEAL PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:RITUDEEP
Authorized Official - Middle Name:
Authorized Official - Last Name:BASRA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:908-397-2310
Mailing Address - Street 1:3 STEPHENVILLE PKWY STE 2C
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-3061
Mailing Address - Country:US
Mailing Address - Phone:908-397-2310
Mailing Address - Fax:
Practice Address - Street 1:3 STEPHENVILLE PKWY STE 2C
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-3061
Practice Address - Country:US
Practice Address - Phone:908-397-2310
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-11
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA07223002251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty