Healthcare Provider Details

I. General information

NPI: 1720211220
Provider Name (Legal Business Name): CONCORD HEALTH AND REHABILITATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2009
Last Update Date: 08/31/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 CONCORD AVE STE 101
WILMINGTON DE
19802-3366
US

IV. Provider business mailing address

3 HOVTECH BLVD
MOUNT LAUREL NJ
08054-6306
US

V. Phone/Fax

Practice location:
  • Phone: 302-777-5551
  • Fax:
Mailing address:
  • Phone: 856-235-0202
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberC1-0005879
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberF-10000687
License Number StateDE

VIII. Authorized Official

Name: JUDITH A COMERS
Title or Position: OFFICE MANAGER
Credential:
Phone: 856-235-0202