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1952852709 NPI number — FIVE ELEMENT REHAB, LLC

NPI Number: 1952852709
Health Care Provider/Practitioner: FIVE ELEMENT REHAB, LLC

Information about “1952852709” NPI (FIVE ELEMENT REHAB, LLC) exists in 1952852709 in HTML format HTML  |  1952852709 in plain Text format TXT  |  1952852709 in PDF (Portable Document Format) PDF  |  1952852709 in an XML format XML  formats.

NPI Number : 1952852709 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1952852709",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "FIVE ELEMENT REHAB, LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "725 RIVER RD",
    "SecondLineMailingAddress": "SUITE 201",
    "MailingAddressCityName": "EDGEWATER",
    "MailingAddressStateName": "NJ",
    "MailingAddressPostalCode": "07020-1171",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "201-943-7768",
    "MailingAddressFaxNumber": "201-943-7798",
    "FirstLinePracticeLocationAddress": "725 RIVER RD",
    "SecondLinePracticeLocationAddress": "SUITE 201",
    "PracticeLocationAddressCityName": "EDGEWATER",
    "PracticeLocationAddressStateName": "NJ",
    "PracticeLocationAddressPostalCode": "07020-1171",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "201-943-7768",
    "PracticeLocationAddressFaxNumber": "201-943-7798",
    "EnumerationDate": "10/17/2016",
    "LastUpdateDate": "10/17/2016",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "LEE",
    "AuthorizedOfficialFirstName": "EUGENE",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "OWNER",
    "AuthorizedOfficialNamePrefix": "DR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "D.C.",
    "AuthorizedOfficialTelephoneNumber": "201-943-7768",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "111N00000X",
          "TaxonomyName": "Chiropractor",
          "LicenseNumber": "38MC00636500",
          "LicenseNumberStateCode": "NJ",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "225100000X",
          "TaxonomyName": "Physical Therapist",
          "LicenseNumber": "40QA00353600",
          "LicenseNumberStateCode": "NJ",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        }
      ]
    }
  }
}
                
            

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