Healthcare Provider Details

I. General information

NPI: 1023920444
Provider Name (Legal Business Name): INCREDIBLE REHAB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

370 CAMPUS DR STE 113A
SOMERSET NJ
08873-1181
US

IV. Provider business mailing address

2407 PARK PL
SCOTCH PLAINS NJ
07076-2129
US

V. Phone/Fax

Practice location:
  • Phone: 201-912-1387
  • Fax:
Mailing address:
  • Phone: 201-912-1387
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: DYNABEN PATEL
Title or Position: PHYSICAL THERAPIST
Credential:
Phone: 201-912-1387