Basic Information
| Provider Information | |||||||||
| NPI: | 1720043474 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CAPE ATLANTIC PHYSICAL THERAPY,PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 222 NEW RD | ||||||||
| Address2: | CENTRAL PARK EAST, BLDG 5, STE 503 | ||||||||
| City: | LINWOOD | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 082211299 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6099261161 | ||||||||
| FaxNumber: | 6099263223 | ||||||||
| Practice Location | |||||||||
| Address1: | 222 NEW RD | ||||||||
| Address2: | CENTRAL PARK EAST, BLDG 5, STE 503 | ||||||||
| City: | LINWOOD | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 082211299 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6099261161 | ||||||||
| FaxNumber: | 6099263223 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/18/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | ZAULYCZNY | ||||||||
| AuthorizedOfficialFirstName: | WALTER | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT OWNER | ||||||||
| AuthorizedOfficialTelephone: | 6099261161 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | MSPT | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2251X0800X | NJ | X | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Orthopedic | 2251S0007X | NJ | X | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Sports |
No ID Information.