Healthcare Provider Details

I. General information

NPI: 1457066532
Provider Name (Legal Business Name): BRAINBUILDERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2023
Last Update Date: 01/23/2023
Certification Date: 01/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

945 RIVER AVE
LAKEWOOD NJ
08701-5659
US

IV. Provider business mailing address

945 RIVER AVE
LAKEWOOD NJ
08701-5659
US

V. Phone/Fax

Practice location:
  • Phone: 732-833-3723
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: RACHEL SOROTZKIN
Title or Position: CLINICAL DIRECTOR
Credential:
Phone: 732-833-3723