Provider Demographics
NPI:1649347246
Name:PATERSON PHYSICAL THERAPY, P.C.
Entity type:Organization
Organization Name:PATERSON PHYSICAL THERAPY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KERI
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:FESSLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-305-8830
Mailing Address - Street 1:P.O.BOX 2966
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07509
Mailing Address - Country:US
Mailing Address - Phone:973-305-8830
Mailing Address - Fax:973-305-8818
Practice Address - Street 1:628 BROADWAY
Practice Address - Street 2:2ND FLR.
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07514-1918
Practice Address - Country:US
Practice Address - Phone:973-305-8830
Practice Address - Fax:973-305-8818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities