Organization
IRVINGTON EMERGENT CARE AND REHABILITATION CENTER INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUDOLPH WILLIS MD (OWNER)
(973) 373-3000
Entity
Organization
Contact information
Practice address
12 KROTIK PL, IRVINGTON, NJ 07111-1708
(973) 373-3000
Mailing address
12 KROTIK PL, IRVINGTON, NJ 07111-1708
(973) 373-3000
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA42750
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0887307
—
NJ
Enumeration date
05/25/2006
Last updated
11/05/2007
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