Provider Demographics
NPI:1346050242
Name:LITTLE HEADWAY PEDIATRIC PHYSICAL THERAPY & CRANIAL MOLDING LLC
Entity type:Organization
Organization Name:LITTLE HEADWAY PEDIATRIC PHYSICAL THERAPY & CRANIAL MOLDING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF PHYSICAL THERAPY
Authorized Official - Prefix:
Authorized Official - First Name:JOY
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:813-400-9201
Mailing Address - Street 1:245 SUMMIT AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07304-3110
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:245 SUMMIT AVE APT 1
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07304-3110
Practice Address - Country:US
Practice Address - Phone:813-400-9201
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty