Provider Demographics
NPI:1992457121
Name:ULTRA COMPREHENSIVE PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:ULTRA COMPREHENSIVE PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:JAINESH
Authorized Official - Middle Name:
Authorized Official - Last Name:VASHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-680-8101
Mailing Address - Street 1:246 CLIFTON AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07011-1900
Mailing Address - Country:US
Mailing Address - Phone:862-899-7900
Mailing Address - Fax:862-899-7901
Practice Address - Street 1:634 SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-3705
Practice Address - Country:US
Practice Address - Phone:862-899-7900
Practice Address - Fax:862-899-7901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-19
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty