Basic Information
| Provider Information | |||||||||
| NPI: | 1881650224 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HOPEWELL PHYSICAL THERAPY INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 800 DENOW RD | ||||||||
| Address2: | SUITE U | ||||||||
| City: | PENNINGTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 085345246 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6097378130 | ||||||||
| FaxNumber: | 6097378131 | ||||||||
| Practice Location | |||||||||
| Address1: | 800 DENOW RD | ||||||||
| Address2: | SUITE U | ||||||||
| City: | PENNINGTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 085345246 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6097378130 | ||||||||
| FaxNumber: | 6097378131 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/25/2006 | ||||||||
| LastUpdateDate: | 04/20/2008 | ||||||||
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| AuthorizedOfficialLastName: | BARTOLINO | ||||||||
| AuthorizedOfficialFirstName: | THOMAS | ||||||||
| AuthorizedOfficialMiddleName: | DAVID | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER/PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6097378130 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | MMSC, PT, OCS | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2251X0800X | 40QA00170000 | NJ | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Orthopedic |
ID Information
| ID | Type | State | Issuer | Description | DE3961 | 01 | RAILROAD MEDICARE | OTHER | 125158 | 01 | NJ | AETNA USHC | OTHER | MES044 | 01 | NJ | OXFORD HEALTH PLANS | OTHER |