Provider Demographics
NPI:1316278500
Name:TEANECK PHYSICAL THERAPY AND PAIN MANAGEMENT INC
Entity type:Organization
Organization Name:TEANECK PHYSICAL THERAPY AND PAIN MANAGEMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SYLBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:AMIL
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:862-215-2159
Mailing Address - Street 1:46 MEMPHIS AVE
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07109-1939
Mailing Address - Country:US
Mailing Address - Phone:862-215-2159
Mailing Address - Fax:
Practice Address - Street 1:1182 TEANECK RD
Practice Address - Street 2:SUITE 103
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-4824
Practice Address - Country:US
Practice Address - Phone:862-215-2159
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-27
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJPT4OQA0921200261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation