Organization
THE CENTER FOR PHYSICAL MEDICINE AND REHABILITATION LLC
Active
Organization
THE CENTER FOR PHYSICAL MEDICINE AND REHABILITATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY LLOYD (CREDENTIALING COORDINATOR)
(732) 219-6501
Entity
Organization
Contact information
Practice address
776 SHREWSBURY AVE, STE. 203, TINTON FALLS, NJ 07724-3006
(732) 219-0333
(732) 219-6526
Mailing address
776 SHREWSBURY AVE, STE. 203, TINTON FALLS, NJ 07724-3006
(732) 219-0333
(732) 219-6526
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
MA62353
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0674631
DF CIGNA
—
01
—
0778591
JB CIGNA
—
01
—
1K0329
JB HEALTHNET
NJ
01
—
2598116
DF GHI
—
01
—
26Z741
JB EMPIRE
—
01
—
5218141
JB AETNA
—
01
—
5770149
DF AETNA
—
01
—
6012036
JB GHI
—
01
—
F12448
DF HEALTHNET
NJ
01
—
P00210688
JB RR M'CARE
—
01
—
P1947080
JB OXFORD
—
Enumeration date
11/08/2006
Last updated
08/22/2020
Update your record
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