# ADVANCED PHYSICAL MEDICINE & REHABILATION CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578501524
- **Authorized official:** DR. PETER ANTHONY DENINO JR. D.C. (PARTNER)
- **Authorized official phone:** (732) 202-1200

## Contact information

- **Practice address:** 1645 STATE HIGHWAY 88, BRICK, NJ 08724-3049
- **Practice address phone:** (732) 202-1200
- **Practice address fax:** (732) 202-1300
- **Mailing address:** 1645 STATE HIGHWAY 88, BRICK, NJ 08724-3049
- **Mailing address phone:** (732) 202-1200
- **Mailing address fax:** (732) 202-1300

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | MC003514 | NJ | Yes |
| 174400000X | Specialist | 4OQAO1152600 | NJ | — |

## Other

- **Enumeration date:** 06/03/2006
- **Last updated:** 03/05/2012