Organization · NPI-2

1 Prospect Physical Therapy, LLC

Physical Therapist, Orthopedic · West Orange, NJ

NPI number1356570246
StatusActive
Last updated in NPPESDec 3, 2013

Details

NPI
1356570246
Entity type
Organization (NPI-2)
Legal business name
1 Prospect Physical Therapy, LLC
Organization subpart
No
Enumeration date
Jul 13, 2009
Last updated
Dec 3, 2013

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2251X0800X Physical Therapist, Orthopedic40QA01351300NJYes

Practice location

470 Prospect Ave
Suite 100
West Orange, NJ 07052-4153

Phone 973-731-7877 · Fax 973-731-6332

Mailing address

470 Prospect Ave
Suite 100
West Orange, NJ 07052-4153

Phone 973-731-7877 · Fax 973-731-6332

Authorized official

Elan Araten
Owner/Member
9737317877

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