Provider Demographics
NPI:1801561071
Name:ASTRA PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:ASTRA PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PALLAVI
Authorized Official - Middle Name:
Authorized Official - Last Name:RANWADKAR
Authorized Official - Suffix:
Authorized Official - Credentials:PT, OCS
Authorized Official - Phone:908-208-7271
Mailing Address - Street 1:62 STEPHENVILLE PKWY
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-2615
Mailing Address - Country:US
Mailing Address - Phone:315-601-2144
Mailing Address - Fax:
Practice Address - Street 1:1856 OAK TREE RD
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-2704
Practice Address - Country:US
Practice Address - Phone:908-208-7271
Practice Address - Fax:844-444-1160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-10
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty