Provider Demographics
NPI:1679735229
Name:TOTAL ACTIVATION
Entity type:Organization
Organization Name:TOTAL ACTIVATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:NITIN
Authorized Official - Middle Name:K
Authorized Official - Last Name:CHHODA
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:201-723-7149
Mailing Address - Street 1:240 PROSPECT AVE
Mailing Address - Street 2:225
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-2511
Mailing Address - Country:US
Mailing Address - Phone:201-723-7149
Mailing Address - Fax:206-984-4749
Practice Address - Street 1:240 PROSPECT AVE
Practice Address - Street 2:225
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-2511
Practice Address - Country:US
Practice Address - Phone:201-723-7149
Practice Address - Fax:206-984-4749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-25
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01256200261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy