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General NPI Number Information
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NPI Number | 1801795471
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Entity Type | Organization
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Legal Business Name | MADISON MEDICAL DIAGNOSTICS & SPORTS REHAB CENTTER
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Dates
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Enumeration Date | 11/02/2026
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Last Update Date | 11/02/2026
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Provider Practice Location Address
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Address Line | 345 MAIN ST
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City | MADISON
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State | NJ
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Zip | 07940-2383
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Country | US
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Telephone | 973-377-6700
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Fax | 973-377-8008
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Provider Business Mailing Address
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Address Line | 345 MAIN ST STE 2
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City | MADISON
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State | NJ
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Zip | 07940-2384
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Country | US
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Telephone | 973-377-6700
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Fax | 973-377-8008
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Authorized Official
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Title or Position | COO
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Name | RENEE OLIVEIRA
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Credential |
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Telephone | 917-242-1517
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR0401X
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Taxonomy Name | Comprehensive Outpatient Rehabilitation Facility (CORF)
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License Number |
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License Number State |
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