Provider Demographics
NPI:1023155769
Name:CAJITA AND ASSOCIATES PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:CAJITA AND ASSOCIATES PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHELLA
Authorized Official - Middle Name:Z
Authorized Official - Last Name:CAJITA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-471-8110
Mailing Address - Street 1:PO BOX 50205
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-0205
Mailing Address - Country:US
Mailing Address - Phone:973-471-8110
Mailing Address - Fax:973-471-8111
Practice Address - Street 1:1117 US HIGHWAY 46
Practice Address - Street 2:SUITE 203
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-2449
Practice Address - Country:US
Practice Address - Phone:973-471-8110
Practice Address - Fax:973-471-8111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00804600225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty