Healthcare Provider Details

I. General information

NPI: 1538598404
Provider Name (Legal Business Name): JFKJOHNSON REHAB INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2013
Last Update Date: 11/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 JAMES ST BTU SOCIAL WORK DEPT.
EDISON NJ
08820-3947
US

IV. Provider business mailing address

65 JAMES ST. BTU SOCIAL WORK DEPT.
EDISON NJ
08818-3059
US

V. Phone/Fax

Practice location:
  • Phone: 732-321-7638
  • Fax: 783-274-4585
Mailing address:
  • Phone: 732-321-7638
  • Fax: 783-274-4585

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License Number44SC00866800
License Number StateNJ

VIII. Authorized Official

Name: MS. ANN H GREIM
Title or Position: BTU SOCIAL WORKER
Credential: LCSW
Phone: 732-321-7638