Provider Demographics
NPI:1609885235
Name:PHYSICAL THERAPY OF CLIFTON, P.A.
Entity Type:Organization
Organization Name:PHYSICAL THERAPY OF CLIFTON, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER EMPLOYER
Authorized Official - Prefix:
Authorized Official - First Name:ARLENE
Authorized Official - Middle Name:C
Authorized Official - Last Name:GROSSE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:973-778-1134
Mailing Address - Street 1:1011 CLIFTON AVE
Mailing Address - Street 2:SUITE 5 2ND FLOOR
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-3518
Mailing Address - Country:US
Mailing Address - Phone:973-778-1134
Mailing Address - Fax:973-614-1530
Practice Address - Street 1:1011 CLIFTON AVE
Practice Address - Street 2:SUITE 5 2ND FLOOR
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-3518
Practice Address - Country:US
Practice Address - Phone:973-778-1134
Practice Address - Fax:973-614-1530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJNJ5785OtherHEALTHNET
NJ5933017OtherAETNA
NJDG0150OtherRAILROAD MEDICARE
NJ5503201OtherGHI
NJDG0150OtherRAILROAD MEDICARE