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General NPI Number Information
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NPI Number | 1437684651
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Entity Type | Organization
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Legal Business Name | CENTRAL NEW JERSEY MEDICAL OFFICE, LLC
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Dates
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Enumeration Date | 04/25/2017
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Last Update Date | 04/25/2017
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Provider Practice Location Address
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Address Line | 22 OLD SHORT HILLS RD STE 112
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City | LIVINGSTON
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State | NJ
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Zip | 07039-5607
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Country | US
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Telephone | 732-449-0334
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Fax |
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Provider Business Mailing Address
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Address Line | 22 OLD SHORT HILLS RD STE 112
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City | LIVINGSTON
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State | NJ
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Zip | 07039-5607
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Country | US
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Telephone | 732-449-0334
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | JOHN RUSH
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Credential |
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Telephone | 301-928-1697
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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