Provider Demographics
NPI:1386702959
Name:TRUE PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:TRUE PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:D
Authorized Official - Last Name:HAJEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-728-2270
Mailing Address - Street 1:1 COOPER AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BRANCH
Mailing Address - State:NJ
Mailing Address - Zip Code:07740
Mailing Address - Country:US
Mailing Address - Phone:732-728-2270
Mailing Address - Fax:732-728-2271
Practice Address - Street 1:1 COOPER AVE
Practice Address - Street 2:
Practice Address - City:LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07740
Practice Address - Country:US
Practice Address - Phone:732-728-2270
Practice Address - Fax:732-728-2271
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ070831Medicare ID - Type Unspecified