Provider Demographics
NPI:1881772200
Name:CALDWELL COMMUNITY PHYSICAL THERAPY
Entity type:Organization
Organization Name:CALDWELL COMMUNITY PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:
Authorized Official - Last Name:DANNUNZIO
Authorized Official - Suffix:
Authorized Official - Credentials:PT, OCS, MTC
Authorized Official - Phone:973-575-7576
Mailing Address - Street 1:700 PASSAIC AVE
Mailing Address - Street 2:
Mailing Address - City:WEST CALDWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07006-6408
Mailing Address - Country:US
Mailing Address - Phone:973-575-7576
Mailing Address - Fax:
Practice Address - Street 1:700 PASSAIC AVE
Practice Address - Street 2:
Practice Address - City:WEST CALDWELL
Practice Address - State:NJ
Practice Address - Zip Code:07006-6408
Practice Address - Country:US
Practice Address - Phone:973-575-7576
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty