Healthcare Provider Details

I. General information

NPI: 1285789909
Provider Name (Legal Business Name): REHABILITATION PHYSICIANS OF SOUTH JERSEY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1237 W SHERMAN AVE
VINELAND NJ
08360-6920
US

IV. Provider business mailing address

1237 W SHERMAN AVE
VINELAND NJ
08360-6920
US

V. Phone/Fax

Practice location:
  • Phone: 856-696-7100
  • Fax: 856-696-3065
Mailing address:
  • Phone: 856-696-7100
  • Fax: 856-696-3065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: FRANCIS J BONNER JR.
Title or Position: SOLE MEMBER
Credential: M.D.
Phone: 856-896-2008