Healthcare Provider Details

I. General information

NPI: 1306186762
Provider Name (Legal Business Name): ROBERT WOOD JOHNSON UNIVERSITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2013
Last Update Date: 02/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39 OAKLAND AVE APT 23
BLOOMFIELD NJ
07003-3498
US

IV. Provider business mailing address

39 OAKLAND AVE APT 23
BLOOMFIELD NJ
07003-3498
US

V. Phone/Fax

Practice location:
  • Phone: 973-896-2273
  • Fax:
Mailing address:
  • Phone: 973-896-2273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License Number4OQA01315800
License Number StateNJ

VIII. Authorized Official

Name: DR. ANNA AISHA HUNTER MANNS
Title or Position: PHYSICAL THERAPIST
Credential:
Phone: 973-896-2273