Provider Demographics
NPI:1083460398
Name:THERAFIT ENTERPRISES OF NEW JERSEY INCORPORATED
Entity type:Organization
Organization Name:THERAFIT ENTERPRISES OF NEW JERSEY INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:
Authorized Official - Last Name:GILLIGAN-DELLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-871-2494
Mailing Address - Street 1:618 TURNER DR
Mailing Address - Street 2:
Mailing Address - City:BELFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07718-1139
Mailing Address - Country:US
Mailing Address - Phone:732-639-0068
Mailing Address - Fax:
Practice Address - Street 1:443 HIGHWAY 34 STE J
Practice Address - Street 2:
Practice Address - City:MATAWAN
Practice Address - State:NJ
Practice Address - Zip Code:07747-9506
Practice Address - Country:US
Practice Address - Phone:732-955-9505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-26
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies