Provider Demographics
NPI:1760660500
Name:HEALING JOINTS PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:HEALING JOINTS PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:PURVI
Authorized Official - Middle Name:JIGAR
Authorized Official - Last Name:PITHWA
Authorized Official - Suffix:
Authorized Official - Credentials:MA PT
Authorized Official - Phone:732-662-1784
Mailing Address - Street 1:1214 MURRAY ST
Mailing Address - Street 2:
Mailing Address - City:AVENEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07001-1626
Mailing Address - Country:US
Mailing Address - Phone:732-910-8585
Mailing Address - Fax:732-622-1785
Practice Address - Street 1:1804 OAK TREE RD
Practice Address - Street 2:SUITE # 1
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-2783
Practice Address - Country:US
Practice Address - Phone:732-662-1784
Practice Address - Fax:732-662-1785
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-04
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01104300174400000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ125012Medicare PIN