Provider Demographics
NPI:1669817763
Name:AM PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:AM PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:DREYTSER
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:732-794-3974
Mailing Address - Street 1:2 LINCOLN HWY
Mailing Address - Street 2:STE 510
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-3961
Mailing Address - Country:US
Mailing Address - Phone:732-947-4318
Mailing Address - Fax:732-649-6477
Practice Address - Street 1:2 LINCOLN HWY
Practice Address - Street 2:STE 510
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-3961
Practice Address - Country:US
Practice Address - Phone:732-947-4318
Practice Address - Fax:732-649-6477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-02
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00954300174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty