Organization
CAMELOT REHABILITATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHRYN MARY SHAPIRO P.T. (OWNER)
(732) 747-2300
Entity
Organization
Contact information
Practice address
656 SHREWSBURY AVE, SUITE 102, TINTON FALLS, NJ 07701-4964
(732) 747-2300
(732) 747-2334
Mailing address
656 SHREWSBURY AVE, SUITE 102, TINTON FALLS, NJ 07701-4964
(732) 747-2300
(732) 747-2334
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
40QA00640600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
188607
MEDICARE PTAN
NJ
Enumeration date
10/25/2010
Last updated
05/03/2016
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