Provider Demographics
NPI:1851429773
Name:UNION PHYSICAL THERAPY & REHABILITATION CENTER INC
Entity Type:Organization
Organization Name:UNION PHYSICAL THERAPY & REHABILITATION CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BHARGAVI
Authorized Official - Middle Name:AMISH
Authorized Official - Last Name:DESAI
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:908-286-1515
Mailing Address - Street 1:81 NORTHFIELD AVE
Mailing Address - Street 2:SUIITE 205
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-5342
Mailing Address - Country:US
Mailing Address - Phone:973-325-9285
Mailing Address - Fax:973-325-9295
Practice Address - Street 1:180 SOUTH ST
Practice Address - Street 2:SUITE 102
Practice Address - City:NEW PROVIDENCE
Practice Address - State:NJ
Practice Address - Zip Code:07974-1991
Practice Address - Country:US
Practice Address - Phone:908-286-1515
Practice Address - Fax:908-286-1522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00847000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ079492Medicare ID - Type Unspecified