Organization
DYNAMIC HEALTH REHABILITATION CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GRIGORY HEALTH & SHTENDER MD (PRESIDENT)
(201) 791-7771
Entity
Organization
Contact information
Practice address
31-00 BROADWAY, 1 ST FLOOR, FAIR LAWN, NJ 07410-3963
(201) 791-7771
(201) 791-7337
Mailing address
31-00 BROADWAY, 1 ST FLOOR, FAIR LAWN, NJ 07410
(201) 791-7771
(201) 791-7337
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
25MA07870200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
113571274
INDIVIDUAL NPI
NY
01
—
25MA07870200
LICENSE NUMBER
NJ
Enumeration date
06/05/2014
Last updated
06/05/2014
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