Organization
PEDIATRIC REHABILITATION SPECIALISTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENFU CHENG MD (PHYSICIAN/OWNER)
(908) 605-0259
Entity
Organization
Contact information
Practice address
170 HILL HOLLOW RD, WATCHUNG, NJ 07069-6442
(908) 605-0259
Mailing address
170 HILL HOLLOW RD, WATCHUNG, NJ 07069-6442
(908) 605-0259
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2081P0010X
Pediatric Rehabilitation Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1801862644
NPI
—
01
—
MA07604200
MEDICAL LICENSE
NJ
Enumeration date
06/08/2021
Last updated
11/26/2021
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