| Organization Name: | TIER 1 DIRECT PHYSICAL THERAPY LLC |
| NPI Number: | 1598151185 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | VINCENT GARY DIPERSIA (PHYSICAL THERAPIST/OWNER) |
| Mailing Address: | 330 Congers Ave Northvale |
| State: | NJ US |
| Postal Code: | 076471607 |
| Phone Number: | 2015434078 |
| Fax Number: | 2017841401 |
| NPI Enumeration Date: | 04/09/2015 |
| NPI Last Update Date: | 04/27/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | 40QA01198100 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |