Healthcare Provider Details

I. General information

NPI: 1639105919
Provider Name (Legal Business Name): FALL PREVENTION AND REHABILITATION, LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 MAIN ST SUITE 5
WEST ORANGE NJ
07052-5495
US

IV. Provider business mailing address

77 MAIN ST SUITE 5
WEST ORANGE NJ
07052-5495
US

V. Phone/Fax

Practice location:
  • Phone: 973-324-2111
  • Fax: 732-212-0713
Mailing address:
  • Phone: 973-324-2111
  • Fax: 732-212-0713

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNJ
# 4
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number StateNJ

VIII. Authorized Official

Name: DR. MICHELLE DUBNOFF
Title or Position: PRESIDENT
Credential: DC
Phone: 973-324-2111