Healthcare Provider Details

I. General information

NPI: 1720137409
Provider Name (Legal Business Name): PALISADES REHABILITATION SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 03/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 KNICKERBOCKER RD
CRESSKILL NJ
07626-1827
US

IV. Provider business mailing address

220 KNICKERBOCKER RD
CRESSKILL NJ
07626-1827
US

V. Phone/Fax

Practice location:
  • Phone: 201-541-9222
  • Fax: 201-541-1711
Mailing address:
  • Phone: 201-541-9222
  • Fax: 201-541-1711

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

VIII. Authorized Official

Name: MRS. DEBORAH MUELLER LONGEST
Title or Position: VICE-PRESIDENT
Credential: OTR L
Phone: 201-541-9222