Organization
JERSEY REHAB PA
Active
Parent organization
JERSEY REHAB PA PC
Other names
Jersey Rehab PA PC ( NY office only)
Organization subpart
Yes
Provider details
NPI number
Legal business name
JERSEY REHAB PA PC
Authorized official
ROBERT A. MARINI MD (MD)
(973) 482-1614
Entity
Organization
Contact information
Practice address
3146 E TREMONT AVE, BRONX, NY 10461-5706
(718) 792-6503
(718) 792-0096
Mailing address
15 NEWARK AVE, BELLEVILLE, NJ 07109-1123
(973) 482-1614
(973) 485-6126
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
A178991-2
NY
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
A178991-2
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1629005012
GROUP NPI NUMBER FOR MEDICARE NJ - NY AND NJ DME
NJ
01
—
6540890001
DME NUMBER FOR NJ - PTAN
NJ
Enumeration date
03/08/2007
Last updated
06/20/2014
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