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PRO FORM SPORTS MEDICINE AND WELLNESS ASSOCIATES
NPI 1235432972
Emergency Medicine - Sports Medicine in Rutherford, NJ

Active since December 20, 2010
201 ROUTE 17, 11TH FLOOR, RUTHERFORD, NJ 07070(201) 549-8846(201) 549-8839 Get Directions Write a Review

NPPES record last updated: December 20, 2010. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Pro Form Sports Medicine And Wellness Associates NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PRO FORM SPORTS MEDICINE AND WELLNESS ASSOCIATES (NPI 1235432972) is a healthcare organization registered as a sports medicine in Rutherford, New Jersey and active in the NPI registry since December 2010. The organization lists Tae Keun Park, Partner, as its authorized official.

NPPES Registry Identity

NPI1235432972
Entity TypeOrganization
Primary Taxonomy207PS0010X
Legal Business NamePRO FORM SPORTS MEDICINE AND WELLNESS ASSOCIATES
Location Address201 ROUTE 17, 11TH FLOORRutherford, NJ 07070-2574
Mailing Address201 Route 17, 11th FloorRutherford, NJ 07070-2574 · (201) 549-8846 · Fax (201) 549-8839
Phone(201) 549-8846
Fax(201) 549-8839
Organization SubpartNo
Authorized OfficialTae Keun ParkPartner · (646) 489-5640
Enumeration DateDecember 20, 2010
✔ NPI 1235432972 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency Medicine · Sports MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207PS0010X
License✔ Licensed in NJ · 25MA08835000
Definition
An emergency physician with special knowledge in sports medicine is responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention and management of injury and illness. A sports medicine physician has knowledge and experience in the promotion of wellness and the role of exercise in promoting a healthy lifestyle. Knowledge of exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation and epidemiology is essential to the practice of sports medicine.
201 ROUTE 17, Rutherford, NJ 07070
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

COMPLETE FOOT AND ANKLE - MALO
Podiatrist (Foot & Ankle Surgery)
201 ROUTE 17, 11TH FLOOR
RUTHERFORD, NJ 07070
Bergen County (201) 445-2288
INSTITUTE FOR NERVE, HAND AND RECONSTRUCTIVE SURGERY LLC
Plastic Surgery (Surgery of the Hand)
201 ROUTE 17, 11TH FLOOR, ROOM 11056
RUTHERFORD, NJ 07070
Bergen County (201) 549-8860
MALO CLINIC ADVANCED REHABILITATION,LLC
Dentist (Oral and Maxillofacial Surgery)
201 ROUTE 17, 11TH FLOOR
RUTHERFORD, NJ 07070
Bergen County (201) 528-2297
MALO CONSULTING NJ LLC
Clinic/Center (Health Service)
201 ROUTE 17
RUTHERFORD, NJ 07070
Bergen County (201) 549-8815
MOBILE MEDICAL SERVICES OF NEW JERSEY, PC
Anesthesiology
201 ROUTE 17, 12TH FLOOR
RUTHERFORD, NJ 07070
Bergen County (201) 372-1689
DR. WOOIL STEVEN PARK D.D.S.
Dentist (Prosthodontics)
201 ROUTE 17, 11TH FLOOR
RUTHERFORD, NJ 07070
Bergen County (201) 549-8811
AJIT M. SHAH, MD PC
Internal Medicine
201 ROUTE 17
RUTHERFORD, NJ 07070
Bergen County (201) 549-8890
DR. DHARA SHAH DDS
Dentist (General Practice)
201 ROUTE 17, 12TH FLOOR
RUTHERFORD, NJ 07070
Bergen County (201) 549-8817

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 Pro Form Sports Medicine And Wellness Associates's NPI number?

The NPI number for Pro Form Sports Medicine And Wellness Associates is 1235432972. It was assigned to this organization in the NPPES registry on December 20, 2010.

Where is Pro Form Sports Medicine And Wellness Associates located?

Pro Form Sports Medicine And Wellness Associates is located at 201 Route 17 11th Floor, Rutherford, NJ 07070. The listed phone number is (201) 549-8846.

What is Pro Form Sports Medicine And Wellness Associates's specialty?

The primary specialty registered for this NPI is Emergency Medicine, specializing in Sports Medicine, with taxonomy code 207PS0010X.

When was this NPI record last updated?

The NPPES record for Pro Form Sports Medicine And Wellness Associates was last updated on December 20, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.