Provider Demographics
NPI:1801281472
Name:NORUM PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:NORUM PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:GERARD
Authorized Official - Last Name:NORUM
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:551-777-3502
Mailing Address - Street 1:95 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:PEARL RIVER
Mailing Address - State:NY
Mailing Address - Zip Code:10965-1708
Mailing Address - Country:US
Mailing Address - Phone:551-777-3502
Mailing Address - Fax:
Practice Address - Street 1:210 SUMMIT AVE
Practice Address - Street 2:SUITE A1A
Practice Address - City:MONTVALE
Practice Address - State:NJ
Practice Address - Zip Code:07645-1579
Practice Address - Country:US
Practice Address - Phone:551-777-3502
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-31
Last Update Date:2015-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00798900261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy