Provider Demographics
NPI:1689989543
Name:ADELPHIA PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:ADELPHIA PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:EASTBURN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:732-370-7880
Mailing Address - Street 1:2119 WHITESVILLE RD
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-2600
Mailing Address - Country:US
Mailing Address - Phone:732-370-7880
Mailing Address - Fax:732-370-2040
Practice Address - Street 1:721 W KENNEDY BLVD
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-1255
Practice Address - Country:US
Practice Address - Phone:732-905-8787
Practice Address - Fax:732-905-6668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-16
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty