Provider Demographics
NPI:1598707234
Name:COMPREHENSIVE ORTHOPEDIC PHYSICAL THERAPY
Entity Type:Organization
Organization Name:COMPREHENSIVE ORTHOPEDIC PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:GILMARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-846-9400
Mailing Address - Street 1:900 EASTON AVE
Mailing Address - Street 2:SUITE 22
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-1760
Mailing Address - Country:US
Mailing Address - Phone:732-846-9400
Mailing Address - Fax:732-846-9404
Practice Address - Street 1:900 EASTON AVE
Practice Address - Street 2:SUITE 22
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-1760
Practice Address - Country:US
Practice Address - Phone:732-846-9400
Practice Address - Fax:732-846-9404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2015-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ087012Medicare ID - Type Unspecified