Provider Demographics
NPI:1609315258
Name:DRAYER PHYSICAL THERAPY OF NEW JERSEY LLC
Entity Type:Organization
Organization Name:DRAYER PHYSICAL THERAPY OF NEW JERSEY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BARGANIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-536-7602
Mailing Address - Street 1:1200 CORPORATE DR STE 400
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35242-5424
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:423-933-1996
Practice Address - Street 1:131 NEW RD
Practice Address - Street 2:SUITE 4
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054-4208
Practice Address - Country:US
Practice Address - Phone:973-396-8728
Practice Address - Fax:973-396-8732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-15
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty