Provider Demographics
NPI:1932644754
Name:SPECTRUM THERAPEUTICS OF NJ LLC
Entity Type:Organization
Organization Name:SPECTRUM THERAPEUTICS OF NJ LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:LETIZIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-595-6066
Mailing Address - Street 1:401 HAMBURG TPKE STE 105
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-2139
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:401 HAMBURG TPKE STE 105
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2139
Practice Address - Country:US
Practice Address - Phone:973-595-6066
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-03
Last Update Date:2017-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy