| Bergen Physical Therapy, Llc | |
|
520 Main St, Fort Lee, NJ 07024-4501 | |
| (201) 947-7805 | |
| (201) 947-7806 |
| Full Name | Bergen Physical Therapy, Llc |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 520 Main St, Fort Lee, New Jersey |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013446954 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | (* (Not Available)) | Primary |
| 171100000X | Acupuncturist | (* (Not Available)) | Secondary |
| 225100000X | Physical Therapist | (* (Not Available)) | Secondary |
| Provider Name | Mario Glavicic |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1659383578 PECOS PAC ID: 0244200053 Enrollment ID: I20040729000204 |
| Provider Name | Peter T Kofitsas |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1669622437 PECOS PAC ID: 2567426448 Enrollment ID: I20041119000351 |
| Mailing Address | Practice Location Address |
|---|---|
| Bergen Physical Therapy, Llc 520 Main St, Fort Lee, NJ 07024-4501 Ph: (201) 947-7805 | Bergen Physical Therapy, Llc 520 Main St, Fort Lee, NJ 07024-4501 Ph: (201) 947-7805 |
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