Provider Demographics
NPI:1386491892
Name:SCHROTH SPINAL PHYSICAL THERAPY OF COASTAL JERSEY
Entity type:Organization
Organization Name:SCHROTH SPINAL PHYSICAL THERAPY OF COASTAL JERSEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:EGE
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:973-851-3234
Mailing Address - Street 1:88-2 PORTLAND RD
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS
Mailing Address - State:NJ
Mailing Address - Zip Code:07732
Mailing Address - Country:US
Mailing Address - Phone:973-851-3234
Mailing Address - Fax:
Practice Address - Street 1:4 HENDRICKSON AVE STE 4
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-6155
Practice Address - Country:US
Practice Address - Phone:973-851-3234
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-02
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty