Healthcare Provider Details

I. General information

NPI: 1326199084
Provider Name (Legal Business Name): FIRST REHAB SOUTH AMBOY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 07/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

404 MAIN ST SITE A
SPOTSWOOD NJ
08884-1794
US

IV. Provider business mailing address

4557 US HIGHWAY 9 SUITE 202
HOWELL NJ
07731-3382
US

V. Phone/Fax

Practice location:
  • Phone: 732-254-1990
  • Fax: 732-254-1551
Mailing address:
  • Phone: 732-886-1900
  • Fax: 732-886-1950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: YAAKOV FRIEDMAN
Title or Position: MANAGING MEMBER
Credential:
Phone: 732-886-1900