Provider Demographics
NPI:1578804605
Name:RARITAN PHYSICAL THERAPY
Entity Type:Organization
Organization Name:RARITAN PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:866-871-6229
Mailing Address - Street 1:16 CAMPUS DR
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08837-3911
Mailing Address - Country:US
Mailing Address - Phone:866-871-6229
Mailing Address - Fax:888-739-5830
Practice Address - Street 1:16 CAMPUS DR
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08837-3911
Practice Address - Country:US
Practice Address - Phone:866-871-6229
Practice Address - Fax:888-739-5830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-14
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01445800208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty