Provider Demographics
NPI:1467052209
Name:MAXIMUM HEALTH PHYSICAL THERAPY OF LONG VALLEY, PC
Entity Type:Organization
Organization Name:MAXIMUM HEALTH PHYSICAL THERAPY OF LONG VALLEY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:REILLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-547-3680
Mailing Address - Street 1:6 VICTORIA DR
Mailing Address - Street 2:
Mailing Address - City:FLANDERS
Mailing Address - State:NJ
Mailing Address - Zip Code:07836-9634
Mailing Address - Country:US
Mailing Address - Phone:973-945-0720
Mailing Address - Fax:
Practice Address - Street 1:62 E MILL RD STE A2
Practice Address - Street 2:
Practice Address - City:LONG VALLEY
Practice Address - State:NJ
Practice Address - Zip Code:07853-3118
Practice Address - Country:US
Practice Address - Phone:085-202-3779
Practice Address - Fax:908-509-6207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-30
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy