Healthcare Provider Details

I. General information

NPI: 1487186193
Provider Name (Legal Business Name): TRINITY REHAB SOMERSET PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2017
Last Update Date: 11/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

89 ROUTE 206
SOMERVILLE NJ
08876-4102
US

IV. Provider business mailing address

554 HIGHWAY 35
RED BANK NJ
07701-5066
US

V. Phone/Fax

Practice location:
  • Phone: 908-393-2180
  • Fax: 908-800-0500
Mailing address:
  • Phone: 732-219-5700
  • Fax: 732-334-3003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL RIZKALLA
Title or Position: CEO
Credential: OTR/L, MLDT
Phone: 732-219-5700