Provider Demographics
NPI:1790021830
Name:ALIGN NATURAL PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:ALIGN NATURAL PHYSICAL THERAPY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHEVAUN
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRSCHBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:551-804-0608
Mailing Address - Street 1:104 OLD TAPPAN RD
Mailing Address - Street 2:
Mailing Address - City:OLD TAPPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07675-7434
Mailing Address - Country:US
Mailing Address - Phone:551-804-0608
Mailing Address - Fax:201-767-0768
Practice Address - Street 1:104 OLD TAPPAN RD
Practice Address - Street 2:
Practice Address - City:OLD TAPPAN
Practice Address - State:NJ
Practice Address - Zip Code:07675-7434
Practice Address - Country:US
Practice Address - Phone:551-804-0608
Practice Address - Fax:201-767-0768
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-18
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01385800225100000X
NY032774225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty