Provider Demographics
NPI:1790929081
Name:PERFECT PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:PERFECT PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:S
Authorized Official - Last Name:KADE
Authorized Official - Suffix:
Authorized Official - Credentials:MS PT
Authorized Official - Phone:973-325-0229
Mailing Address - Street 1:81 NORTHFIELD AVE
Mailing Address - Street 2:SUITE104
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-5342
Mailing Address - Country:US
Mailing Address - Phone:973-325-0229
Mailing Address - Fax:973-325-1105
Practice Address - Street 1:81 NORTHFIELD AVE
Practice Address - Street 2:SUITE104
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-5342
Practice Address - Country:US
Practice Address - Phone:973-325-0229
Practice Address - Fax:973-325-1105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-30
Last Update Date:2009-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01004800261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ140367Medicare UPIN