Healthcare Provider Details

I. General information

NPI: 1285562744
Provider Name (Legal Business Name): INTEGRATIVE REHABILITATION PT PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

274 W BROADWAY
LONG BEACH NY
11561-3911
US

IV. Provider business mailing address

1105 E COUNTY LINE RD STE 213
LAKEWOOD NJ
08701-2178
US

V. Phone/Fax

Practice location:
  • Phone: 732-399-9700
  • Fax: 516-308-2981
Mailing address:
  • Phone: 732-399-9700
  • Fax: 516-308-2981

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: AVRAHAM FRIEDMAN
Title or Position: OWNER
Credential:
Phone: 732-399-9700