Provider Demographics
NPI:1639390511
Name:MOVE PHYSICAL THERAPY
Entity Type:Organization
Organization Name:MOVE PHYSICAL THERAPY
Other - Org Name:MEDICAL ORTHOPEDIC VARIABLE & EQUIP
Other - Org Type:Other Name
Authorized Official - Title/Position:COLLECTIONS MGR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:SPOONER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-393-9038
Mailing Address - Street 1:777 TERRACE AVE
Mailing Address - Street 2:
Mailing Address - City:HASBROUCK HGTS
Mailing Address - State:NJ
Mailing Address - Zip Code:07604
Mailing Address - Country:US
Mailing Address - Phone:201-393-9038
Mailing Address - Fax:201-393-0509
Practice Address - Street 1:777 TERRACE AVE
Practice Address - Street 2:
Practice Address - City:HASBROUCK HGTS
Practice Address - State:NJ
Practice Address - Zip Code:07604
Practice Address - Country:US
Practice Address - Phone:201-393-9038
Practice Address - Fax:201-393-0509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2020-08-22
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
O27758Medicare UPIN