Provider Demographics
| NPI: | 1124991054 |
|---|---|
| Name: | THERAPHYSICAL LLC |
| Entity type: | Organization |
| Organization Name: | THERAPHYSICAL LLC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | OWNER |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | MAGDALENA |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | BUCZEK |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | DPT |
| Authorized Official - Phone: | 973-277-3911 |
| Mailing Address - Street 1: | 623 RIDGE ROAD |
| Mailing Address - Street 2: | |
| Mailing Address - City: | LYNDHURST |
| Mailing Address - State: | NJ |
| Mailing Address - Zip Code: | 07071 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 201-340-4656 |
| Mailing Address - Fax: | 201-340-4580 |
| Practice Address - Street 1: | 1030 MCBRIDE AVE |
| Practice Address - Street 2: | |
| Practice Address - City: | WOODLAND PARK |
| Practice Address - State: | NJ |
| Practice Address - Zip Code: | 07424 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 973-339-9913 |
| Practice Address - Fax: | 973-339-9914 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | Yes |
| Parent Organization LBN: | THERAPHYSICAL LLC |
| Parent Organization TIN: | <UNAVAIL> |
| Enumeration Date: | 2025-09-26 |
| Last Update Date: | 2025-09-26 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 2251X0800X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Orthopedic | Group - Single Specialty |