Provider Demographics
NPI:1720769011
Name:EMBER PHYSICAL THERAPY P.C.
Entity type:Organization
Organization Name:EMBER PHYSICAL THERAPY P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FIONA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:MCMAHON
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:551-244-1186
Mailing Address - Street 1:3-03 SADDLE RIVER RD
Mailing Address - Street 2:
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-5620
Mailing Address - Country:US
Mailing Address - Phone:207-385-3130
Mailing Address - Fax:
Practice Address - Street 1:10 SYCAMORE AVE
Practice Address - Street 2:
Practice Address - City:HO HO KUS
Practice Address - State:NJ
Practice Address - Zip Code:07423-1587
Practice Address - Country:US
Practice Address - Phone:551-244-1186
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-28
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty