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General NPI Number Information
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NPI Number | 1184869034
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Entity Type | Organization
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Legal Business Name | DYNAMIC REHAB PHYSICAL THERAPY PC
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Dates
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Enumeration Date | 12/06/2008
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Last Update Date | 09/24/2013
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Provider Practice Location Address
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Address Line | 18 WORLDS FAIR DR
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City | SOMERSET
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State | NJ
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Zip | 08873-1346
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Country | US
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Telephone | 732-469-5300
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Fax | 800-917-7162
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Provider Business Mailing Address
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Address Line | 14119 HOOVER AVE
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City | BRIARWOOD
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State | NY
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Zip | 11435-1109
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Country | US
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Telephone | 917-576-7789
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPY
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Name | DR. ROBERT ARANBAEV
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Credential | D.P.T
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Telephone | 917-576-7789
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 40QA01274700
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License Number State | NJ
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