Provider Demographics
NPI:1922343276
Name:DB ORTHOPEDIC PHYSICAL THERAPY OF MANALAPAN, LLC
Entity Type:Organization
Organization Name:DB ORTHOPEDIC PHYSICAL THERAPY OF MANALAPAN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:BERTONE
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:732-747-1262
Mailing Address - Street 1:120 CRAIG RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-3250
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:120 CRAIG RD
Practice Address - Street 2:SUITE 4
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-3250
Practice Address - Country:US
Practice Address - Phone:732-747-1262
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DB ORTHOPEDIC PHYSICAL THERAPY, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-11-27
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNJ40QA00442600225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty