Healthcare Provider Details

I. General information

NPI: 1144267402
Provider Name (Legal Business Name): PC REHABILITATION MEDICINE AND PHYSICAL THERAPY, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

960 PLEASANT VALLEY WAY
WEST ORANGE NJ
07052-1803
US

IV. Provider business mailing address

960 PLEASANT VALLEY WAY
WEST ORANGE NJ
07052-1803
US

V. Phone/Fax

Practice location:
  • Phone: 973-243-1177
  • Fax: 973-243-9077
Mailing address:
  • Phone: 973-243-1177
  • Fax: 973-243-9077

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251E1300X
TaxonomyClinical Electrophysiology Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. THOMAS J. CAVA
Title or Position: CO-DIRECTOR
Credential: M.D.
Phone: 973-243-1177