Provider Demographics
NPI:1851755896
Name:ROM KIDS PEDIATRIC PHYSICAL THERAPY INC
Entity Type:Organization
Organization Name:ROM KIDS PEDIATRIC PHYSICAL THERAPY INC
Other - Org Name:MAGICAL HANDS PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALFIERIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-343-0612
Mailing Address - Street 1:83C DORSET LN
Mailing Address - Street 2:
Mailing Address - City:MONROE TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-6735
Mailing Address - Country:US
Mailing Address - Phone:732-343-0612
Mailing Address - Fax:
Practice Address - Street 1:83C DORSET LN
Practice Address - Street 2:
Practice Address - City:MONROE TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08831-6735
Practice Address - Country:US
Practice Address - Phone:732-343-0612
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-06
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00342900225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty