Healthcare Provider Details

I. General information

NPI: 1922219963
Provider Name (Legal Business Name): MONMOUTH BACK & NECK REHABILITATION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 CRAIG RD
MANALAPAN NJ
07726-8742
US

IV. Provider business mailing address

300 CRAIG ROAD
MANALAPAN NJ
07726
US

V. Phone/Fax

Practice location:
  • Phone: 732-780-8832
  • Fax: 732-845-1344
Mailing address:
  • Phone: 732-780-8832
  • Fax: 732-845-1344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: DR. ANTHONY M DINONNO
Title or Position: OWNER
Credential: D.C.
Phone: 732-780-8832