Provider Demographics
NPI:1598272783
Name:ACTIVE NJ PHYSICAL THERAPY INC
Entity Type:Organization
Organization Name:ACTIVE NJ PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:NICK
Authorized Official - Middle Name:
Authorized Official - Last Name:JAROMAHUM
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:862-222-4528
Mailing Address - Street 1:35 NEW STAR RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07871-3000
Mailing Address - Country:US
Mailing Address - Phone:862-222-4528
Mailing Address - Fax:
Practice Address - Street 1:35 NEW STAR RIDGE ROAD
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:NJ
Practice Address - Zip Code:07871
Practice Address - Country:US
Practice Address - Phone:862-222-4528
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA0826300261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy