Healthcare Provider Details

I. General information

NPI: 1497754006
Provider Name (Legal Business Name): THE REHABILITATION HOSPITAL AT RARITAN BAY MEDICAL CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2005
Last Update Date: 04/19/2023
Certification Date: 04/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 WILLIAMSON ST, 7 NORTH
ELIZABETH NJ
07202-3625
US

IV. Provider business mailing address

530 NEW BRUNSWICK AVENUE
PERTH AMBOY NJ
08861
US

V. Phone/Fax

Practice location:
  • Phone: 908-994-5288
  • Fax:
Mailing address:
  • Phone: 732-324-6095
  • Fax: 732-324-6091

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282E00000X
TaxonomyLong Term Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: MR. A. ALBERTO LUGO
Title or Position: EXECUTIVE VP & GENERAL COUNSEL
Credential:
Phone: 201-242-4000