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General NPI Number Information
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NPI Number | 1578879474
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Entity Type | Organization
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Legal Business Name | HEART & SOUL REHABILITATION
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Dates
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Enumeration Date | 08/30/2010
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Last Update Date | 01/24/2012
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Provider Practice Location Address
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Address Line | 733 BLOOMFIELD AVE
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City | BLOOMFIELD
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State | NJ
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Zip | 07003-2545
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Country | US
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Telephone | 973-748-8100
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Fax | 973-748-1055
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Provider Business Mailing Address
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Address Line | 733 BLOOMFIELD AVE
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City | BLOOMFIELD
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State | NJ
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Zip | 07003-2545
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Country | US
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Telephone | 973-748-8100
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Fax | 973-748-1055
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Authorized Official
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Title or Position | OWNER
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Name | ROBERT W EGERMAYER
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Credential | P.T.
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Telephone | 973-748-8100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | QA006740
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License Number State | NJ
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