Basic Information
Provider Information
NPI: 1508105420
EntityType: 2
ReplacementNPI:  
OrganizationName: JERSEY PHYSICAL THERAPY OF PRINCETON-PLAINSBORO
LastName:  
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Mailing Information
Address1: 3 LIBERTY ST
Address2: SUITE 1032
City: PLAINSBORO
State: NJ
PostalCode: 085362084
CountryCode: US
TelephoneNumber: 7322970032
FaxNumber: 7322970558
Practice Location
Address1: 3 LIBERTY ST
Address2: SUITE 1032
City: PLAINSBORO
State: NJ
PostalCode: 085362084
CountryCode: US
TelephoneNumber: 7322970032
FaxNumber: 7322970558
Other Information
ProviderEnumerationDate: 02/13/2013
LastUpdateDate: 02/13/2013
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: RUBENSTEIN
AuthorizedOfficialFirstName: MARC
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: CO-OWNER
AuthorizedOfficialTelephone: 6097501095
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: DR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: DPT
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X  Y193400000X SINGLE SPECIALTY GROUPRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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