Provider Demographics
NPI:1033096714
Name:ABUHARTHIEH, OMAR M (DPT)
Entity type:Individual
Prefix:
First Name:OMAR
Middle Name:M
Last Name:ABUHARTHIEH
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11-26 SADDLE RIVER RD
Mailing Address - Street 2:
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-5634
Mailing Address - Country:US
Mailing Address - Phone:201-509-8205
Mailing Address - Fax:
Practice Address - Street 1:23-00 ROUTE 208
Practice Address - Street 2:
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-1559
Practice Address - Country:US
Practice Address - Phone:201-509-8205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-16
Last Update Date:2025-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA02357800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist