Healthcare Provider Details
I. General information
NPI: 1194490870
Provider Name (Legal Business Name): BEDMINSTER HOMECARE PT
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/13/2021
Last Update Date: 08/13/2021
Certification Date: 08/13/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
703 TIMBERBROOKE DR
BEDMINSTER NJ
07921-2111
US
IV. Provider business mailing address
703 TIMBERBROOKE DR
BEDMINSTER NJ
07921-2111
US
V. Phone/Fax
- Phone: 908-420-2240
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
GABRIEL
JACOB
EISNER
Title or Position: PHYSICAL THERAPIST
Credential: PT, DPT
Phone: 908-420-2240