| Organization Name: | SPORTS MEDICINE CENTER OF BERGEN, PA |
| NPI Number: | 1073995304 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GARY FLINK (VICE PRESIDENT) |
| Mailing Address: | 1019 Macarthur Blvd Excel Orthopedic Rehabilitation Mahwah |
| State: | NJ US |
| Postal Code: | 07430 |
| Phone Number: | 2018188711 |
| Fax Number: | 2018188744 |
| NPI Enumeration Date: | 06/23/2015 |
| NPI Last Update Date: | 05/24/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |