Provider Demographics
NPI:1871688119
Name:PLAYGROUND TO LEARN LLC
Entity Type:Organization
Organization Name:PLAYGROUND TO LEARN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BALA
Authorized Official - Middle Name:M
Authorized Official - Last Name:PILLAI
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT,MA,PCS
Authorized Official - Phone:908-227-2139
Mailing Address - Street 1:84 ROSS HALL BLVD N
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-5813
Mailing Address - Country:US
Mailing Address - Phone:908-227-2139
Mailing Address - Fax:
Practice Address - Street 1:84 ROSS HALL BLVD N
Practice Address - Street 2:
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854-5813
Practice Address - Country:US
Practice Address - Phone:908-227-2139
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJQA00514400225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ097884Medicare ID - Type Unspecified