Provider Demographics
NPI:1700320231
Name:THERAZONE PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:THERAZONE PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DPT, OCS, CLT / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAMA
Authorized Official - Middle Name:
Authorized Official - Last Name:VARATKAR
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:908-864-4097
Mailing Address - Street 1:884 US HIGHWAY 22
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-1560
Mailing Address - Country:US
Mailing Address - Phone:908-864-4097
Mailing Address - Fax:908-864-4110
Practice Address - Street 1:884 US HIGHWAY 22
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08876-1560
Practice Address - Country:US
Practice Address - Phone:908-864-4097
Practice Address - Fax:908-864-4110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-19
Last Update Date:2017-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01317900261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy