Provider Demographics
NPI:1558440438
Name:THE THERAPY CENTER AT WILSON TOWERS
Entity Type:Organization
Organization Name:THE THERAPY CENTER AT WILSON TOWERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REHAB DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ALDOU
Authorized Official - Middle Name:
Authorized Official - Last Name:CINCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-589-8300
Mailing Address - Street 1:41 WILSON AVENUE
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07105
Mailing Address - Country:US
Mailing Address - Phone:973-589-8300
Mailing Address - Fax:
Practice Address - Street 1:THE THERAPY CENTER
Practice Address - Street 2:41 WILSON AVENUE
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07105
Practice Address - Country:US
Practice Address - Phone:973-589-8300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ111N00000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty