Provider Demographics
NPI:1699213470
Name:CORE PT LLC
Entity Type:Organization
Organization Name:CORE PT LLC
Other - Org Name:GINDI HOME REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:GINDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-660-5422
Mailing Address - Street 1:11 ELINORE AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BRANCH
Mailing Address - State:NJ
Mailing Address - Zip Code:07740-4824
Mailing Address - Country:US
Mailing Address - Phone:732-660-6422
Mailing Address - Fax:732-362-4497
Practice Address - Street 1:1776 AVENUE OF THE STATES STE 301
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-4592
Practice Address - Country:US
Practice Address - Phone:732-660-5422
Practice Address - Fax:732-362-4497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-01
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01714600261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY041097OtherLICENSE#
NJ40QA01714600OtherLICENSE#