Provider Demographics
NPI:1528757317
Name:BPTC LLC
Entity type:Organization
Organization Name:BPTC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:HECTOR
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:617-817-0456
Mailing Address - Street 1:43 CHESTNUT RD
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-2632
Mailing Address - Country:US
Mailing Address - Phone:617-817-0456
Mailing Address - Fax:
Practice Address - Street 1:43 CHESTNUT RD
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-2632
Practice Address - Country:US
Practice Address - Phone:617-817-0456
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-05
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Single Specialty