Provider Demographics
NPI:1124271747
Name:COMPLETE CARE PHYSICAL THERAPY
Entity type:Organization
Organization Name:COMPLETE CARE PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:QUIZON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:201-773-0404
Mailing Address - Street 1:8-14 SADDLE RIVER RD
Mailing Address - Street 2:
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-5733
Mailing Address - Country:US
Mailing Address - Phone:201-773-0404
Mailing Address - Fax:201-773-0405
Practice Address - Street 1:8-14 SADDLE RIVER RD
Practice Address - Street 2:
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-5733
Practice Address - Country:US
Practice Address - Phone:201-773-0404
Practice Address - Fax:201-773-0405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-28
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
NJ40QA01120400261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1659579456OtherNPPES
1124271747OtherNPPES