Provider Demographics
NPI:1891988291
Name:ADVANCED HEALTH & PHYSICAL THERAPY SOLUTIONS
Entity Type:Organization
Organization Name:ADVANCED HEALTH & PHYSICAL THERAPY SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:J
Authorized Official - Last Name:LAVIGNE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:908-766-5663
Mailing Address - Street 1:40 MORRISTOWN RD STE 1B
Mailing Address - Street 2:
Mailing Address - City:BERNARDSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07924-2310
Mailing Address - Country:US
Mailing Address - Phone:908-766-5663
Mailing Address - Fax:908-766-7768
Practice Address - Street 1:30 MORRISTOWN RD
Practice Address - Street 2:
Practice Address - City:BERNARDSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07924-2316
Practice Address - Country:US
Practice Address - Phone:908-766-5663
Practice Address - Fax:908-766-7768
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-20
Last Update Date:2018-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC 04886111N00000X
NJQA09583225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ066977Medicare PIN