Provider Demographics
NPI:1871962175
Name:PURSUE PHYSICAL THERAPY & PERFORMANCE TRAINING
Entity type:Organization
Organization Name:PURSUE PHYSICAL THERAPY & PERFORMANCE TRAINING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:PT,DPT,OCS,CSCS
Authorized Official - Phone:973-271-3368
Mailing Address - Street 1:271 GROVE AVE STE C
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:NJ
Mailing Address - Zip Code:07044-1729
Mailing Address - Country:US
Mailing Address - Phone:201-340-4846
Mailing Address - Fax:
Practice Address - Street 1:271 GROVE AVE STE C
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:NJ
Practice Address - Zip Code:07044-1729
Practice Address - Country:US
Practice Address - Phone:201-340-4846
Practice Address - Fax:973-513-6105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-17
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00129400171100000X
NJ40QA015147002251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSportsGroup - Single Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1134580988OtherNPI- JASON PARK
NJ1407273642OtherNPI
NJ1447684642OtherNPI
NJ1033612163OtherACUPUNCTURE