Provider Demographics
NPI:1922268796
Name:NICOLAPT LLC
Entity Type:Organization
Organization Name:NICOLAPT LLC
Other - Org Name:CAPE ATLANTIC PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLA
Authorized Official - Middle Name:A
Authorized Official - Last Name:OWEN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:609-926-1161
Mailing Address - Street 1:222 NEW RD
Mailing Address - Street 2:BLDG 5 SUITE 503
Mailing Address - City:LINWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08221-1299
Mailing Address - Country:US
Mailing Address - Phone:609-926-1161
Mailing Address - Fax:
Practice Address - Street 1:222 NEW RD BLDG 5
Practice Address - Street 2:
Practice Address - City:LINWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08221-1299
Practice Address - Country:US
Practice Address - Phone:609-926-1161
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-14
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00572700261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy