Organization
JERSEY PM & R LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CORAZON CIPRIASO MD (PHYSICIAN-IN-CHARGE)
(908) 601-5296
Entity
Organization
Contact information
Practice address
25 MULE ROAD, SUITE B-1, TOMS RIVER, NJ 08755-0025
(732) 492-8241
(732) 521-7960
Mailing address
PO BOX 790, OLD BRIDGE, NJ 08857-0790
(732) 492-8241
(732) 521-7960
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
25MA07358200
NJ
225400000X
Rehabilitation Practitioner
—
—
Other
Enumeration date
09/06/2007
Last updated
08/10/2010
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