Healthcare Provider Details

I. General information

NPI: 1952459141
Provider Name (Legal Business Name): CORNERSTONE REHABILITATION SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2007
Last Update Date: 10/07/2020
Certification Date: 10/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 ATLANTIC STREET #1
HACKENSACK NJ
07601-4133
US

IV. Provider business mailing address

133 ATLANTIC STREET #1
HACKENSACK NJ
07601-4133
US

V. Phone/Fax

Practice location:
  • Phone: 201-982-1687
  • Fax: 201-250-8186
Mailing address:
  • Phone: 201-982-1687
  • Fax: 201-250-8186

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. OLADIPO OLATUNBOSUN AMUSAN
Title or Position: PRESIDENT
Credential: DPT
Phone: 201-982-1687