Provider Demographics
NPI:1992323489
Name:5 POINT PHYSICAL THERAPY AND WELLNESS LLC
Entity type:Organization
Organization Name:5 POINT PHYSICAL THERAPY AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:FUTTERMAN TAURIELLO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:212-226-2066
Mailing Address - Street 1:4 JENNIFER LN
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07040-1365
Mailing Address - Country:US
Mailing Address - Phone:773-991-3382
Mailing Address - Fax:212-500-0039
Practice Address - Street 1:318 MAIN ST STE 200A
Practice Address - Street 2:
Practice Address - City:MILLBURN
Practice Address - State:NJ
Practice Address - Zip Code:07041-1181
Practice Address - Country:US
Practice Address - Phone:212-226-2066
Practice Address - Fax:212-500-0039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-10
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Single Specialty