Provider Demographics
NPI:1861428310
Name:A.C. PHYSICAL THERAPY SERVICES, INC.
Entity type:Organization
Organization Name:A.C. PHYSICAL THERAPY SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LIAQAT
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAZAD
Authorized Official - Suffix:
Authorized Official - Credentials:PHYSICAL THERAPIST
Authorized Official - Phone:609-645-2224
Mailing Address - Street 1:2406 NEW RD
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08225-1409
Mailing Address - Country:US
Mailing Address - Phone:609-645-2224
Mailing Address - Fax:609-646-0609
Practice Address - Street 1:2406 NEW RD
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08225-1409
Practice Address - Country:US
Practice Address - Phone:609-645-2224
Practice Address - Fax:609-646-0609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00361700225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ68001OtherCIGNAORTHONET
PA0098435000OtherAMERIHEALTH
NJ=========OtherPROVIDER ID
GAP00164651Medicare ID - Type UnspecifiedRAILROAD MEDICARE
NJ031249Medicare ID - Type UnspecifiedEMPIRE MEDICARE