Provider Demographics
NPI:1508125840
Name:FAMILY CHOICE PHYSICAL THERAPY PA
Entity Type:Organization
Organization Name:FAMILY CHOICE PHYSICAL THERAPY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CZARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:OMBAJIN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:973-928-4004
Mailing Address - Street 1:811 CLIFTON AVE
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-1872
Mailing Address - Country:US
Mailing Address - Phone:973-928-4004
Mailing Address - Fax:
Practice Address - Street 1:811 CLIFTON AVE
Practice Address - Street 2:1ST FLOOR
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-1872
Practice Address - Country:US
Practice Address - Phone:973-928-4004
Practice Address - Fax:973-928-4014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-07
Last Update Date:2017-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy