Provider Demographics
NPI:1588114680
Name:PARAMUS ORTHOPEDIC PHYSICAL THERAPY
Entity type:Organization
Organization Name:PARAMUS ORTHOPEDIC PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BURTON
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:201-880-9810
Mailing Address - Street 1:326 MACARTHUR AVE
Mailing Address - Street 2:
Mailing Address - City:GARFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07026-1122
Mailing Address - Country:US
Mailing Address - Phone:201-602-3226
Mailing Address - Fax:
Practice Address - Street 1:28 FARVIEW TER
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-2740
Practice Address - Country:US
Practice Address - Phone:201-880-9810
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-12
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01675600305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization