# JERSEY REHAB PA

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Jersey Rehab PA PC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629005012
- **Authorized official:** DR. EDWIN M. GANGEMI M.D. (MD)
- **Authorized official phone:** (973) 482-1614

## Contact information

- **Practice address:** 15 NEWARK AVE, BELLEVILLE, NJ 07109-1123
- **Practice address phone:** (973) 844-9220
- **Practice address fax:** (973) 844-9221
- **Mailing address:** 15 NEWARK AVE, BELLEVILLE, NJ 07109-1123
- **Mailing address phone:** (973) 482-1614
- **Mailing address fax:** (973) 485-6126

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | — |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | — | — |

## Other

- **Enumeration date:** 06/28/2006
- **Last updated:** 10/23/2012