Provider Demographics
NPI:1528042082
Name:REGIONAL PHYSICAL THERAPY
Entity Type:Organization
Organization Name:REGIONAL PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:F
Authorized Official - Last Name:LOOBY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:201-991-9272
Mailing Address - Street 1:586 KEARNY AVE
Mailing Address - Street 2:2 FL
Mailing Address - City:KEARNY
Mailing Address - State:NJ
Mailing Address - Zip Code:07032-2806
Mailing Address - Country:US
Mailing Address - Phone:201-991-9272
Mailing Address - Fax:201-991-1532
Practice Address - Street 1:586 KEARNY AVE
Practice Address - Street 2:2 FL
Practice Address - City:KEARNY
Practice Address - State:NJ
Practice Address - Zip Code:07032-2806
Practice Address - Country:US
Practice Address - Phone:201-991-9272
Practice Address - Fax:201-991-1532
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1K9058OtherHEALTH NET
NJ25201OtherCIGNA (ORTHONET)