FORM FUNCTIONAL HEALTH LLC
NPI 1043999196
Clinic/Center - Physical Therapy in Ridgewood, NJ
About Form Functional Health Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
FORM FUNCTIONAL HEALTH LLC (NPI 1043999196) is a healthcare organization registered as a physical therapy in Ridgewood, New Jersey and active in the NPI registry since July 2023. The organization lists Raffaele Lagonigro, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Form Functional Health LLC's NPI number?
The NPI number for Form Functional Health LLC is 1043999196. It was assigned to this organization in the NPPES registry on July 17, 2023.
Where is Form Functional Health LLC located?
Form Functional Health LLC is located at 15 Godwin Ave Ste 1, Ridgewood, NJ 07450. The listed phone number is (973) 841-4800.
What is Form Functional Health LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Physical Therapy, with taxonomy code 261QP2000X.
When was this NPI record last updated?
The NPPES record for Form Functional Health LLC was last updated on April 12, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.