Organization
THERAPRO-CORF, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAVI TIKOO (CEO)
(917) 536-8940
Entity
Organization
Contact information
Practice address
9225 KENNEDY BLVD, NORTH BERGEN, NJ 07047-5361
(201) 869-2701
(201) 869-2717
Mailing address
9225 KENNEDY BLVD, NORTH BERGEN, NJ 07047-5361
(201) 869-2701
(201) 869-2717
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
—
—
Other
Enumeration date
01/28/2008
Last updated
04/04/2013
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