Healthcare Provider Details

I. General information

NPI: 1528843232
Provider Name (Legal Business Name): RENEW THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2023
Last Update Date: 08/30/2023
Certification Date: 08/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1608 ROUTE 88 STE 301
BRICK NJ
08724-3009
US

IV. Provider business mailing address

1608 ROUTE 88 STE 301
BRICK NJ
08724-3009
US

V. Phone/Fax

Practice location:
  • Phone: 732-903-1985
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: MINDEE POSEN
Title or Position: MEDICARE ADMINISTRATION OFFICER
Credential:
Phone: 732-903-1958