Healthcare Provider Details

I. General information

NPI: 1922171560
Provider Name (Legal Business Name): BACHARACH INSTITUTE FOR REHABILITATION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 11/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

61 W JIMMIE LEEDS ROAD
POMONA NJ
08240-0723
US

IV. Provider business mailing address

61 W JIMMIE LEEDS ROAD
POMONA NJ
08240-0723
US

V. Phone/Fax

Practice location:
  • Phone: 609-652-7000
  • Fax: 609-748-7755
Mailing address:
  • Phone: 609-652-7000
  • Fax: 609-748-7755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateNJ

VIII. Authorized Official

Name: MS. NANCY F. PRICE
Title or Position: DIRECTOR PATIENT FINANCIAL SERVICES
Credential: CPAM
Phone: 609-748-5454