Provider Demographics
NPI:1831249036
Name:MIDDLESEX PHYSICAL THERAPY SERVICES INC.
Entity type:Organization
Organization Name:MIDDLESEX PHYSICAL THERAPY SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:QURBAN
Authorized Official - Middle Name:ALI
Authorized Official - Last Name:BABAR
Authorized Official - Suffix:
Authorized Official - Credentials:P T
Authorized Official - Phone:732-324-2121
Mailing Address - Street 1:40 NEW BRUNSWICK AVE
Mailing Address - Street 2:
Mailing Address - City:PERTH AMBOY
Mailing Address - State:NJ
Mailing Address - Zip Code:08861-5000
Mailing Address - Country:US
Mailing Address - Phone:732-324-2121
Mailing Address - Fax:732-324-2422
Practice Address - Street 1:40 NEW BRUNSWICK AVE
Practice Address - Street 2:
Practice Address - City:PERTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08861-5000
Practice Address - Country:US
Practice Address - Phone:732-324-2121
Practice Address - Fax:732-324-2422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00342200174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ520231Medicare PIN
NJR32283Medicare UPIN