Provider Demographics
NPI:1932518149
Name:ULTIMATE PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:ULTIMATE PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:SABBAGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-345-8200
Mailing Address - Street 1:922 MAIN STREET
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07503
Mailing Address - Country:US
Mailing Address - Phone:973-345-8200
Mailing Address - Fax:
Practice Address - Street 1:922 MAIN ST
Practice Address - Street 2:SUITE 101
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07503-2602
Practice Address - Country:US
Practice Address - Phone:973-345-8200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-13
Last Update Date:2014-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy