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General NPI Number Information
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NPI Number | 1245423235
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Entity Type | Organization
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Legal Business Name | CENTRAL JERSEY REHAB ASSOCIATES P.C.
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Dates
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Enumeration Date | 08/22/2007
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Last Update Date | 07/30/2013
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Provider Practice Location Address
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Address Line | 100 PROFESSIONAL VIEW DRIVE SUITE 103
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City | FREEHOLD
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State | NJ
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Zip | 07728-2526
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Country | US
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Telephone | 732-431-6674
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Fax | 732-780-3752
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Provider Business Mailing Address
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Address Line | 100 PROFESSIONAL VIEW DRIVE SUITE 103
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City | FREEHOLD
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State | NJ
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Zip | 07728-2526
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Country | US
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Telephone | 732-431-6674
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Fax | 732-780-3752
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. RICHARD RYAN
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Credential | DC
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Telephone | 732-431-6674
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | MC04442
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License Number State | NJ
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