Organization Name: | INTEGRATED PHYSICAL THERAPY LLC |
NPI Number: | 1568876233 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOHN JAY GIANNELLI (PHYSICAL THERAPIST/OWNER) |
Mailing Address: | 860 Wyckoff Ave Unit 1 Nw Mahwah |
State: | NJ US |
Postal Code: | 074303186 |
Phone Number: | 2019042051 |
Fax Number: | |
NPI Enumeration Date: | 06/20/2014 |
NPI Last Update Date: | 09/22/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2000X |
License Number: | 40QA00288000 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Physical Therapy |
Taxonomy Definition: |