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General NPI Number Information
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NPI Number | 1881667277
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Entity Type | Organization
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Legal Business Name | BEACHWOOD LOW BACK REHAB CENTER
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Dates
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Enumeration Date | 02/08/2006
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Last Update Date | 04/16/2009
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Provider Practice Location Address
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Address Line | 137 ATLANTIC CITY BLVD SUITE 2
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City | BEACHWOOD
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State | NJ
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Zip | 08722-2935
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Country | US
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Telephone | 732-244-8666
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Fax | 732-244-0450
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Provider Business Mailing Address
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Address Line | 137 ATLANTIC CITY BLVD SUITE 2
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City | BEACHWOOD
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State | NJ
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Zip | 08722-2935
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Country | US
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Telephone | 732-244-8666
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Fax | 732-244-0450
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. STEVEN J POLLACK
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Credential | DC
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Telephone | 732-244-8666
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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 | 40QA00497000
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 25MA03808800
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License Number State | NJ
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