Provider Demographics
NPI:1801016746
Name:ADVANCE PHYSICAL THERAPYAND FITNESS INC.
Entity Type:Organization
Organization Name:ADVANCE PHYSICAL THERAPYAND FITNESS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:MCELDUFF
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:732-897-1174
Mailing Address - Street 1:2040 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-6101
Mailing Address - Country:US
Mailing Address - Phone:732-897-1174
Mailing Address - Fax:
Practice Address - Street 1:2040 6TH AVE
Practice Address - Street 2:
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-6101
Practice Address - Country:US
Practice Address - Phone:732-897-1174
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ038536Medicare ID - Type Unspecified