Provider Demographics
NPI:1053125641
Name:RAISE THE BAR PHYSICAL THERAPY PC
Entity type:Organization
Organization Name:RAISE THE BAR PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:BRIANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:CALLISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-519-9136
Mailing Address - Street 1:11 ELM ST
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-3507
Mailing Address - Country:US
Mailing Address - Phone:845-519-9136
Mailing Address - Fax:
Practice Address - Street 1:184 GODWIN AVE
Practice Address - Street 2:COM UNIT 2
Practice Address - City:MIDLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:07432
Practice Address - Country:US
Practice Address - Phone:845-519-9136
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-04
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy