Healthcare Provider Details

I. General information

NPI: 1528235827
Provider Name (Legal Business Name): NORTH JERSEY REHABILITATION CENTER P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2008
Last Update Date: 05/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 VAN NOSTRAND AVE
ENGLEWOOD CLIFFS NJ
07632-1555
US

IV. Provider business mailing address

120 VAN NOSTRAND AVE
ENGLEWOOD CLIFFS NJ
07632-1555
US

V. Phone/Fax

Practice location:
  • Phone: 201-944-5999
  • Fax: 201-947-3994
Mailing address:
  • Phone: 201-944-5999
  • Fax: 201-947-3994

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number38MC00507000
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA01076000
License Number StateNJ

VIII. Authorized Official

Name: DR. WILLIAM K YU
Title or Position: PRESIDENT
Credential: D.C.
Phone: 201-944-5999