Provider Demographics
NPI:1891877957
Name:SYNERGY PHYSICAL THERAPY & SPORTS TRAINING
Entity Type:Organization
Organization Name:SYNERGY PHYSICAL THERAPY & SPORTS TRAINING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MEG
Authorized Official - Middle Name:
Authorized Official - Last Name:ZARNICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-538-8600
Mailing Address - Street 1:210 MALAPARDIS RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CEDAR KNOLLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07927-1109
Mailing Address - Country:US
Mailing Address - Phone:973-538-8600
Mailing Address - Fax:973-538-8646
Practice Address - Street 1:210 MALAPARDIS RD
Practice Address - Street 2:SUITE 101
Practice Address - City:CEDAR KNOLLS
Practice Address - State:NJ
Practice Address - Zip Code:07927-1109
Practice Address - Country:US
Practice Address - Phone:973-538-8600
Practice Address - Fax:973-538-8646
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00915900225100000X
NJ41YS00371600235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ095060Medicare ID - Type Unspecified