Healthcare Provider Details

I. General information

NPI: 1740708825
Provider Name (Legal Business Name): EWING REHAB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2017
Last Update Date: 09/08/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 W UPPER FERRY RD
EWING NJ
08628-2736
US

IV. Provider business mailing address

80 W UPPER FERRY RD
EWING NJ
08628-2736
US

V. Phone/Fax

Practice location:
  • Phone: 845-517-2652
  • Fax: 845-517-2654
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ALIZA EBSTEIN
Title or Position: MANAGER
Credential:
Phone: 845-517-2652