Provider Demographics
NPI:1720128481
Name:UNITED THERAPEUTIC SOLUTIONS LLC
Entity Type:Organization
Organization Name:UNITED THERAPEUTIC SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CRISPIN
Authorized Official - Middle Name:
Authorized Official - Last Name:DE GUZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:848-203-1545
Mailing Address - Street 1:18 IMPERIAL CT
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-2162
Mailing Address - Country:US
Mailing Address - Phone:848-203-1546
Mailing Address - Fax:732-605-0576
Practice Address - Street 1:18 IMPERIAL CT
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NJ
Practice Address - Zip Code:08831-2162
Practice Address - Country:US
Practice Address - Phone:848-203-1546
Practice Address - Fax:732-605-0576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2014-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00725500225100000X
NJ40QA00680600225100000X
NJ40QA00738700225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
276477Medicare PIN