MEDICARE: MR. ERWIN CEBRECUS

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	225XP0019X	Physical Rehabilitation Occupational Therapist	46TR00503100	NJ

General Provider Information

NPI Number	:	1639729924
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ERWIN CEBRECUS

Provider Business Mailing Address
First Line	:	44 RUGBY RD
Second Line	:
City	:	CEDAR GROVE
State	:	NJ
Zip	:	07009-1707
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	198 OLD BERGEN RD # 2622
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07305-2622
Country	:	US
Telephone Number	:	888-560-5995
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/18/2019
Last Update Date	:	09/18/2019

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Directions to “ MR. ERWIN CEBRECUS ” Practice Location

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