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General NPI Number Information
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NPI Number | 1881925675
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Entity Type | Organization
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Legal Business Name | CLASSIC REHABILITATION
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Dates
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Enumeration Date | 01/19/2010
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Last Update Date | 01/19/2010
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Provider Practice Location Address
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Address Line | 500 RIVER AVE
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City | LAKEWOOD
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State | NJ
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Zip | 08701-4738
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Country | US
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Telephone | 732-367-1888
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Fax | 732-367-5910
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Provider Business Mailing Address
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Address Line | 500 RIVER AVE
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City | LAKEWOOD
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State | NJ
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Zip | 08701-4738
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Country | US
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Telephone | 732-367-1888
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Fax | 732-367-5910
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MARC LUBET
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Credential |
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Telephone | 732-367-1888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 0C010760
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 46TR00065700
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License Number State | NJ
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