Form Functional Health LLC
NPI 1043999196 · Physical Therapy Clinic/Center · Ridgewood, NJ
Form Functional Health LLC is a Physical Therapy Clinic/Center organization in Ridgewood, NJ (NPI 1043999196).
Provider details
- NPI number
- 1043999196
- Entity type
- Organization
- Primary specialty
- Physical Therapy Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Raffaele Lagonigro, Owner(973) 464-6356
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2023-07-17
- Last updated
- 2024-04-12
- Certified
- 2024-04-12
Frequently asked questions
- What is Form Functional Health LLC's NPI number?
- Form Functional Health LLC's National Provider Identifier (NPI) is 1043999196, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Form Functional Health LLC?
- Form Functional Health LLC is classified in the NPPES registry as Physical Therapy Clinic/Center (Ambulatory Health Care Facilities).
- Where is Form Functional Health LLC located?
- Form Functional Health LLC's practice location on file with NPPES is 15 Godwin Ave Ste 1, Ridgewood, NJ 07450-3739.
- What is Form Functional Health LLC's phone number?
- The practice phone number listed in the NPPES registry for Form Functional Health LLC is (973) 841-4800.
- Who is the authorized official for Form Functional Health LLC?
- The authorized official listed on Form Functional Health LLC's NPPES record is Raffaele Lagonigro, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Form Functional Health LLC's NPI active?
- Yes — Form Functional Health LLC's NPI (1043999196) is active in the NPPES registry as of the last update on 2024-04-12.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.