| NPI | 1275050619 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEMETRI E. DIMITRIADIS Owner 201-588-6290 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01409300) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: NJ 40QA01409300) |
| 2251X0800X Physical Therapist, Orthopedic (Licence: NJ 40QA01409300) | |
| 261QP2000X Clinic/Center, Physical Therapy (Licence: NJ 40QA01409300) | |
| Enumeration Date | 2017-08-26 |
| Last Update Date | 2024-10-09 |