Healthcare Provider Details

I. General information

NPI: 1891055737
Provider Name (Legal Business Name): JB NURSING AND REHAB SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2012
Last Update Date: 07/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7310 BERGENLINE AVE
NORTH BERGEN NJ
07047-5437
US

IV. Provider business mailing address

209 COMLY RD APT C-14
LINCOLN PARK NJ
07035-1126
US

V. Phone/Fax

Practice location:
  • Phone: 201-590-9999
  • Fax:
Mailing address:
  • Phone: 630-788-0477
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number40QA01398200
License Number StateNJ

VIII. Authorized Official

Name: JOHN BUCO
Title or Position: PHYSICAL THERAPIST
Credential:
Phone: 630-788-0477