Pro Form Sports Medicine And Wellness Associates
Emergency Medicine, Sports Medicine in Rutherford, New Jersey
1235432972- Practice location
- 201 Route 17, 11TH Floor, Rutherford, NJ 07070-2574
- Phone
- 201-549-8846
- Fax
- 201-549-8839
- Last updated
- December 20, 2010
Pro Form Sports Medicine And Wellness Associates is a healthcare organization based in Rutherford, NJ. Pro Form Sports Medicine And Wellness Associates practices in Rutherford, NJ. The NPI Number for Pro Form Sports Medicine And Wellness Associates is 1235432972 and holds a License No. 25MA08835000 (NJ). The current practice location address for Pro Form Sports Medicine And Wellness Associates is 201 Route 17, 11TH Floor, Rutherford, NJ 07070-2574 and can be reached out via phone at 201-549-8846 and via fax at 201-549-8839.
Provider Profile Details
- NPI Number
- 1235432972
- Provider Name
- Pro Form Sports Medicine And Wellness Associates
- Provider Entity Type
- Organization
- Address
- 201 Route 17, 11TH Floor, Rutherford, NJ 07070-2574
- Phone Number
- 201-549-8846
- Fax Number
- 201-549-8839
- Primary Taxonomy
- Emergency Medicine, Sports Medicine · 207PS0010X
- Organization Subpart
- No
- Authorized Official
- Dr. Tae Keun Park, MD · Partner · 646-489-5640
- Provider Enumeration Date
- December 20, 2010
- Last Update Date
- December 20, 2010
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 201 Route 17
11TH Floor
Rutherford, NJ 07070-2574 - City
- Rutherford
- State
- New Jersey
- Zip
- 07070-2574
- Phone Number
- 201-549-8846
- Fax Number
- 201-549-8839
Provider Business Mailing Address Details
- Address
- 201 Route 17
11TH Floor
Rutherford, NJ 07070-2574 - City
- Rutherford
- State
- NJ
- Zip
- 07070-2574
- Phone Number
- 201-549-8846
- Fax Number
- 201-549-8839
License Information
- License Number
- 25MA08835000
- License State
- NJ
- Taxonomy
- Emergency Medicine, Sports Medicine · 207PS0010X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Pro Form Sports Medicine And Wellness Associates?
The NPI number of Pro Form Sports Medicine And Wellness Associates is 1235432972. It was assigned on December 20, 2010 and is currently active in the NPPES registry.
What is the specialty of Pro Form Sports Medicine And Wellness Associates?
Pro Form Sports Medicine And Wellness Associates is registered under the primary taxonomy Emergency Medicine, Sports Medicine (code 207PS0010X), licensed in NJ under license number 25MA08835000.
Where does Pro Form Sports Medicine And Wellness Associates practice?
The practice location is 201 Route 17, 11TH Floor, Rutherford, NJ 07070-2574. The office can be reached at 201-549-8846 (phone) or 201-549-8839 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1235432972 directly on the NPPES registry website.