PEDIATRIC REHABILITATION OF NORTH JERSEY PC NPI 1396897773

NPI Information

NPI: 1396897773
Provider Name: PEDIATRIC REHABILITATION OF NORTH JERSEY PC
Classification: Clinic/Center - 261QR0401X
Entity Type: Organization

Specialization: Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)

Address:
309 BLACK OAK RIDGE RD
WAYNE, NJ
ZIP 07470
Phone: (973) 628-1300
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PEDIATRIC REHABILITATION OF NORTH JERSEY PC is a rehabilitation and comprehensive outpatient rehabilitation facility (corf) clinic center in Wayne, NJ. PEDIATRIC REHABILITATION OF NORTH JERSEY PC NPI is 1396897773. The provider is registered as an organization entity type.

The provider's business location address is:

309 BLACK OAK RIDGE RD
WAYNE, NJ
ZIP 07470-504
Phone: (973) 628-1300
Fax: (973) 628-0300

The provider's authorized official is Marissa M Muccio .
The authorized official title is President and has the following contact phone number (973) 628-1300.

The enumeration date for this NPI number is 1/17/2007 and was last updated on 3/18/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR0401X	Clinic/Center	Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)	40QA00794200	NEW JERSEY	Yes

What is NPI?

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This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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