MEDICARE: FORT LEE REHABILITATION

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	225100000X	Physical Therapist	NJMCO1411	NJ

General Provider Information

NPI Number	:	1093075160
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FORT LEE REHABILITATION

Provider Business Mailing Address
First Line	:	530 MAIN ST
Second Line	:	SUITE 3
City	:	FORT LEE
State	:	NJ
Zip	:	07024-4506
Country	:	US
Telephone Number	:	201-592-6200
Fax Number	:	201-592-6401

Provider Business Practice Location Address
First Line	:	530 MAIN ST
Second Line	:	SUITE 3
City	:	FORT LEE
State	:	NJ
Zip	:	07024-4506
Country	:	US
Telephone Number	:	201-592-6200
Fax Number	:	201-592-6401

Authorized Official
Title or Position	:	OWNER/PHYSICIAN
Name	:	DR. ANDREW MARK RODGERS
Credential	:	DC
Telephone Number	:	201-592-6200

Provider Enumeration Date	:	05/23/2012
Last Update Date	:	05/23/2012

Similar Medicare Providers

1700959509 — DR. ANDREW M. RODGERS DC
Practice Location Address:

530 MAIN ST
FORT LEE, NJ
07024-4506

Practice Phone: 201-592-6200
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1457540494 — ANDREW M RODGERS
Practice Location Address:

530 MAIN ST , SUITE 2
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07024-4506

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1306159462 — RICHARD C TASHJIAN DC
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530 MAIN ST
FORT LEE, NJ
07024-4506

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1235490483 — JOONGHAE LEE LAC
Practice Location Address:

530 MAIN ST , SUITE 2
FORT LEE, NJ
07024-4506

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Practice Fax: 201-592-6401

1205377207 — SUSAN SUH L.AC
Practice Location Address:

530 MAIN ST
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07024-4506

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1386602613 — SHERWOOD OAKS ENTERPRISES, INC.
Practice Location Address:

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Directions to “FORT LEE REHABILITATION ” Practice Location

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