Provider Demographics
NPI:1861787483
Name:CANA PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:CANA PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHELLA
Authorized Official - Middle Name:ZARAGOZA
Authorized Official - Last Name:CAJITA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:732-321-1909
Mailing Address - Street 1:12 BRIDGE ST
Mailing Address - Street 2:C12
Mailing Address - City:METUCHEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08840-2273
Mailing Address - Country:US
Mailing Address - Phone:732-321-1909
Mailing Address - Fax:732-321-1933
Practice Address - Street 1:12 BRIDGE ST
Practice Address - Street 2:C12
Practice Address - City:METUCHEN
Practice Address - State:NJ
Practice Address - Zip Code:08840-2273
Practice Address - Country:US
Practice Address - Phone:732-321-1909
Practice Address - Fax:732-321-1933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-11
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01250500225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty