Provider Demographics
NPI:1215906912
Name:ALL STAR PHYSICAL THERAPY PA
Entity type:Organization
Organization Name:ALL STAR PHYSICAL THERAPY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ANIL
Authorized Official - Middle Name:
Authorized Official - Last Name:RANA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:973-439-1007
Mailing Address - Street 1:1140 BLOOMFIELD AVENUE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WEST CALDWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07006
Mailing Address - Country:US
Mailing Address - Phone:973-439-1007
Mailing Address - Fax:973-439-1009
Practice Address - Street 1:1140 BLOOMFIELD AVENUE
Practice Address - Street 2:SUITE 100
Practice Address - City:WEST CALDWELL
Practice Address - State:NJ
Practice Address - Zip Code:07006
Practice Address - Country:US
Practice Address - Phone:973-439-1007
Practice Address - Fax:973-439-1009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-15
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ088682Medicare ID - Type Unspecified