Organization
ZMA REHABILITATION SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BURT MICHAEL LACIVITA MS OTR (OWNER)
(201) 923-7533
Entity
Organization
Contact information
Practice address
81 NORTHFIELD AVE, SUITE 104, WEST ORANGE, NJ 07052-5342
(973) 325-0229
(973) 325-1105
Mailing address
141 S CENTRE ST, SOUTH ORANGE, NJ 07079-2609
(201) 923-7533
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
46TR00395600
NJ
Other
Enumeration date
02/18/2011
Last updated
02/18/2011
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