Sports Extra Pc

LBN: Sports Extra Pc
Sports Extra Pc is an health care organization with primary practice located at 67 Walnut Ave Suite 202, Clark NJ 07066-1640. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as the primary health care specialty. Sports Extra Pc can be contacted via phone (732) 388-7300, or through Gilsenan, Michele Theresa via phone (732) 388-7300.

Contact Information

Primary practice address
67 Walnut Ave Suite 202 Clark NJ 07066-1640
Phone: (732) 388-7300
Fax: (732) 388-1330
Website:
Map and Directions
Authorized official contact:
Name: Gilsenan, Michele Theresa Doctor of Osteopathy (DO)
Phone: (732) 388-7300

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X

Profile Details

NPI number 1346296969
LBN Legal business name Sports Extra Pc
DBA Doing business as
Authorized official Gilsenan, Michele Theresa Doctor of Osteopathy (DO)
Entity Organization
Organization subpart 1 No
Enumeration date May 25th, 2006
Last updated Oct 18th, 2007 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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