Healthcare Provider Details

I. General information

NPI: 1952240822
Provider Name (Legal Business Name): MADISON MEDICAL AND SPORTS REHABILITATION L.L.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 MAIN ST
MADISON NJ
07940-2383
US

IV. Provider business mailing address

345 MAIN ST
MADISON NJ
07940-2383
US

V. Phone/Fax

Practice location:
  • Phone: 973-377-6700
  • Fax: 973-377-8008
Mailing address:
  • Phone: 973-377-6700
  • Fax: 973-377-8008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP1100X
TaxonomyPodiatric Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CARMEN ROMANO
Title or Position: CEO
Credential:
Phone: 973-207-4817