LIGHTPORT PHYSICAL THERAPY (NPI# 1730541335) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730541335 |
| Entity Type | Organization |
| Organization Name | LIGHTPORT PHYSICAL THERAPY |
| Practice Address |
355 Bloomfield Ave Caldwell NJ 07006-5118 |
| Practice Telephone | 9732280072 |
| Practice Fax Number | 9732282311 |
| Mailing Telephone | 9732280072 |
| Mailing Fax Number | 0732282311 |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2020-07-23 |
| Authorized Official Name | MR. JOHN DE HOYOS (DR. OF PHYSICAL THERAPY) |
| Authorized Official Telephone | 9732280072 |
| Authorized Official Credential | DPT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
40QA01237600 | NJ | Ambulatory Health Care Facilities |
| Street Address |
355 BLOOMFIELD AVE |
| City | CALDWELL |
| State | NJ |
| Zip Code | 07006-5118 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245876325 | Damian David Daffara | Spec/Tech, Health Info | 355 Bloomfield Ave, Caldwell, NJ 07006-5118 | 2019-11-23 |
| 1255804431 | Yris Vanbrakle | Physical Therapy Assistant | 355 Bloomfield Ave, Caldwell, NJ 07006-5118 | 2019-01-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063984979 | Ethan and The Bean A New Jersey Non Profit Corporation | Assistant Behavior Analyst | 31 Fairfield Avenue, West Caldwell, NJ 07006 | 2018-12-18 |
| 1083104228 | A Plus Rehab LLC | Physical Medicine & Rehabilitation | 9 Bloomfield Ave, North Caldwell, NJ 07006 | 2018-05-14 |
| 1326556564 | Salvatrice Rosalia Polizzotto | Social Worker | 249 Bloomfield Avenue, 2nd Floor, Caldwell, NJ 07006 | 2018-01-22 |
| 1750820452 | Caldwell University | Behavioral Analyst | 120 Bloombfield Avenue, Caldwell, NJ 07006 | 2017-02-15 |
| 1790151116 | Bankim Shah | Internal Medicine | 32 Wakefield Pl, Caldwell, NJ 07006 | 2015-08-19 |
| 1598157638 | Lisa Santeramo | Behavioral Analyst | 309 Westville Avenue, West Caldwell, NJ 07006 | 2015-02-26 |
| 1871832774 | Theodore K Chang | Dentist | 749 Bloomfield Ave Ste D, West Caldwell, NJ 07006 | 2013-02-12 |
| 1801132535 | Booyoung Chung | Pharmacist | 560 Passiac Ave Cvs, West Caldwell, NJ 07006 | 2012-12-28 |
| 1750611802 | Christopher Jones, Dds, P.a. | Dentist | 1129 Bloomfield Avenue, West Caldwell, NJ 07006 | 2010-01-12 |
| 1194976837 | Arthur Edward Halprin | Dentist | 277 Bloomfield Ave., Caldwell, NJ 07006 | 2008-09-30 |
| Find all providers in zip 07006 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619045309 | Altitude Physical Therapy, Inc. | Clinic/Center | 1906 Fairview Ave Ste 410, Caldwell, ID 83605-5424 | 2006-12-01 |
| 1801900212 | Intermountain Physical Therapy Limited Partnership | Clinic/Center | 3110 Cleveland Blvd, Building A Suite 5, Caldwell, ID 83605-0718 | 2006-08-19 |
| 1841589389 | Iron Physical Therapy | Clinic/Center | 474 Bloomfield Ave, Caldwell, NJ 07006-5402 | 2011-04-05 |
| 1265602809 | Rulin J. Hawks, Pt, Pllc | Clinic/Center | 1902 S 10th Ave, Caldwell, ID 83605-4841 | 2008-03-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295336303 | 180degree Therapy | Clinic/Center | 52 Hillcrest Dr, Wayne, NJ 07470-5729 | 2020-11-04 |
| 1467052209 | Maximum Health Physical Therapy of Long Valley, PC | Clinic/Center | 62 E Mill Rd Ste A2, Long Valley, NJ 07853-3118 | 2020-10-30 |
| 1225637861 | Mvmt Performance LLC | Clinic/Center | 133 Eayrestown Rd, Southampton, NJ 08088-9122 | 2020-10-24 |
| 1033718473 | Orthostrength Physical Therapy | Clinic/Center | 8 Eastman St Ste 3, Cranford, NJ 07016-2291 | 2020-10-17 |
| 1356949317 | Coast Physio LLC | Clinic/Center | 140 Metedeconk Rd, Brick, NJ 08723-5442 | 2020-10-13 |
| 1639777964 | Trinity Rehab Somerset Pa | Clinic/Center | 1130 Broad St, Shrewsbury, NJ 07702-4308 | 2020-10-09 |
| 1649878976 | Trinity Rehab Somerset Pa | Clinic/Center | 734 Morris Tpke, Short Hills, NJ 07078-2614 | 2020-10-09 |
| 1336747666 | Trinity Rehab Somerset Pa | Clinic/Center | 910 Hamburg Tpke, Wayne, NJ 07470-3225 | 2020-10-09 |
| 1013514306 | Shoreside In Home Therapy | Clinic/Center | 213 19th Ave, Belmar, NJ 07719-2655 | 2020-10-08 |
| 1164039434 | Cano Physical Therapy | Clinic/Center | 1615 80th St, North Bergen, NJ 07047-4165 | 2020-09-30 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on LIGHTPORT PHYSICAL THERAPY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.