Healthcare Provider Details

I. General information

NPI: 1588671556
Provider Name (Legal Business Name): PRO REHAB, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1931 WASHINGTON VALLEY ROAD
MARTINSVILLE NJ
08836
US

IV. Provider business mailing address

1931 WASHINGTON VALLEY ROAD
MARTINSVILLE NJ
08836
US

V. Phone/Fax

Practice location:
  • Phone: 732-271-1000
  • Fax:
Mailing address:
  • Phone: 732-271-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberMC3749
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License NumberMC3749
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA00925300
License Number StateNJ
# 4
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number40QA00925300
License Number StateNJ

VIII. Authorized Official

Name: DR. EDWARD VINCENT SOFO
Title or Position: SOLE MEMBER/OWNER
Credential: D.C., C.C.S.P.
Phone: 908-604-2042