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SPORTS MEDICINE CENTER OF BERGEN PA NPI 1609990019


NPI Information

NPI: 1609990019
Provider Name: SPORTS MEDICINE CENTER OF BERGEN, PA

Doing Business As: EXCEL ORTHOPEDIC REHABILITATION

Classification: Physical Therapist - 2251S0007X
Entity Type: Organization

Specialization: Sports

Address:
605 MAIN ST
HACKENSACK, NJ
ZIP 07601
Phone: (201) 488-0488
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SPORTS MEDICINE CENTER OF BERGEN, PA is a sports physical therapist in Hackensack, NJ. The provider is a licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Sports Physical Therapy, who has demonstrated specialized knowledge and skill in human anatomy and physiology, movement science, pathology and pathophysiology, medical and surgical intervention, and health and wellness, as well as rehabilitation/return to sports, management of acute injury/illness, medical and surgical consideration, injury prevention, and sports performance enhancement. SPORTS MEDICINE CENTER OF BERGEN, PA NPI is 1609990019. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Excel Orthopedic Rehabilitation.

The provider's business location address is:

605 MAIN ST
HACKENSACK, NJ
ZIP 07601-914
Phone: (201) 488-0488
Fax: (201) 488-5787

The provider's authorized official is Gary Flink .
The authorized official title is Vice President and has the following contact phone number (201) 488-0788.

The enumeration date for this NPI number is 3/19/2007 and was last updated on 5/24/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12251S0007XPhysical TherapistSportsYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1044081MEDICARE ID-TYPE UNSPECIFIEDNEW JERSEY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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