Provider Demographics
NPI:1982847976
Name:ACCELERATED PHYSICAL THERAPY AND REHAB, LLC
Entity Type:Organization
Organization Name:ACCELERATED PHYSICAL THERAPY AND REHAB, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:AMIT
Authorized Official - Middle Name:
Authorized Official - Last Name:GAGLANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-494-0895
Mailing Address - Street 1:3830 PARK AVE
Mailing Address - Street 2:SUITE 208
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-2562
Mailing Address - Country:US
Mailing Address - Phone:732-494-0895
Mailing Address - Fax:732-494-0896
Practice Address - Street 1:3830 PARK AVE
Practice Address - Street 2:SUITE 208
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-2562
Practice Address - Country:US
Practice Address - Phone:732-494-0895
Practice Address - Fax:732-494-0896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-07
Last Update Date:2009-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00819800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ086957Medicare PIN