Organization Name: | MATRIX PHYSICAL THERAPY,LLC |
NPI Number: | 1033105325 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DEBRA A LIEBOWITZ (OWNER) |
Mailing Address: | 222 Kinderkamack Rd Oradell |
State: | NJ US |
Postal Code: | 076492259 |
Phone Number: | 2127940820 |
Fax Number: | 2012659817 |
NPI Enumeration Date: | 09/22/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2000X |
License Number: | 40QA01179000 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Physical Therapy |
Taxonomy Definition: |