Organization
SHORE REHABILITATION INSTITUTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD C SMITH (SR VICE PRESIDENT)
(732) 321-7747
Entity
Organization
Contact information
Practice address
425 JACK MARTIN BLVD, BRICK, NJ 08724-7732
(732) 836-4506
(732) 632-1676
Mailing address
80 JAMES ST, 4TH FLOOR, EDISON, NJ 08820-3938
(732) 632-1571
(732) 632-1676
Taxonomy
Speciality
Code
Description
License number
State
283X00000X
Rehabilitation Hospital
Primary
22219
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6512909
—
NJ
Enumeration date
08/01/2006
Last updated
09/11/2008
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