Provider Demographics
NPI:1407687890
Name:EMPOWER PHYSICAL THERAPY AND WELLNESS CENTER, INC
Entity type:Organization
Organization Name:EMPOWER PHYSICAL THERAPY AND WELLNESS CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JERMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ELBADRY
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:201-790-3121
Mailing Address - Street 1:408 SUMMIT AVE
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-3101
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:408 SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-3101
Practice Address - Country:US
Practice Address - Phone:201-790-3121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-08
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty