Healthcare Provider Details

I. General information

NPI: 1720538929
Provider Name (Legal Business Name): NEW JERSEY REHAB EXPERTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2016
Last Update Date: 10/09/2020
Certification Date: 10/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 WASHINGTON BLVD
JERSEY CITY NJ
07310-1400
US

IV. Provider business mailing address

610 WASHINGTON BLVD
JERSEY CITY NJ
07310-1400
US

V. Phone/Fax

Practice location:
  • Phone: 267-271-8938
  • Fax: 866-966-7882
Mailing address:
  • Phone: 212-227-3233
  • Fax: 866-549-5687

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number40QA01588700
License Number StateNJ

VIII. Authorized Official

Name: SUNNY THAKKAR
Title or Position: DIRECTOR
Credential: PT
Phone: 212-227-3233