Provider Demographics
NPI:1902083751
Name:SOMERSET FAMILY PHYSICAL THERAPY INC
Entity Type:Organization
Organization Name:SOMERSET FAMILY PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KURTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:732-356-5363
Mailing Address - Street 1:14 WORLDS FAIR DRIVE
Mailing Address - Street 2:SUITE M
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873
Mailing Address - Country:US
Mailing Address - Phone:732-356-5363
Mailing Address - Fax:732-356-5364
Practice Address - Street 1:14 WORLDS FAIR DRIVE
Practice Address - Street 2:SUITE M
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873
Practice Address - Country:US
Practice Address - Phone:732-356-5363
Practice Address - Fax:732-356-5364
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-23
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00517400261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ085872Medicare PIN