MEDICARE: PROFESSIONALS IN MEDICAL REHABILITATION LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician

General Provider Information

NPI Number	:	1083973325
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROFESSIONALS IN MEDICAL REHABILITATION LLC

Provider Business Mailing Address
First Line	:	191 NORTH AVE
Second Line	:	SUITE 395
City	:	DUNELLEN
State	:	NJ
Zip	:	08812-1277
Country	:	US
Telephone Number	:	908-757-3915
Fax Number	:

Provider Business Practice Location Address
First Line	:	191 NORTH AVE
Second Line	:	SUITE 395
City	:	DUNELLEN
State	:	NJ
Zip	:	08812-1277
Country	:	US
Telephone Number	:	908-757-3915
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	DR. TALYA K FLEMING
Credential	:	MD
Telephone Number	:	908-757-3915

Provider Enumeration Date	:	05/07/2012
Last Update Date	:	07/30/2012

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