Provider Demographics
NPI:1790075430
Name:ACTIVE RECOVERY, PC
Entity Type:Organization
Organization Name:ACTIVE RECOVERY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGARRY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:973-830-9373
Mailing Address - Street 1:50 ROUTE 46
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-2392
Mailing Address - Country:US
Mailing Address - Phone:973-229-2237
Mailing Address - Fax:
Practice Address - Street 1:50 ROUTE 46
Practice Address - Street 2:SUITE 101
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054-2392
Practice Address - Country:US
Practice Address - Phone:973-229-2237
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-14
Last Update Date:2011-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01176300261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy