Healthcare Provider Details

I. General information

NPI: 1790727220
Provider Name (Legal Business Name): REHABILITATION SPECIALISTS OF NEW JERSEY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 02/19/2020
Certification Date: 02/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 EAGLE ROCK AVE STE 154
EAST HANOVER NJ
07936-3168
US

IV. Provider business mailing address

120 EAGLE ROCK AVE STE 154
EAST HANOVER NJ
07936-3168
US

V. Phone/Fax

Practice location:
  • Phone: 201-407-5145
  • Fax: 862-701-6444
Mailing address:
  • Phone: 201-407-5145
  • Fax: 862-701-6444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number25MA07056000
License Number StateNJ

VIII. Authorized Official

Name: DR. JAMES GIRARDY
Title or Position: PARTNER
Credential: MD
Phone: 201-407-5145