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NPI Code Detail

MEDICARE: JC REHABILITATION LLC

MEDICARE: JC 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
1225X00000XOccupational Therapist

General Provider Information

NPI Number : 1710700620
Entity Type Code : Organization
Provider Name (Legal Business Name) : JC REHABILITATION LLC
Provider Business Mailing Address
First Line : 321 HAMBURG TPKE
Second Line :
City : WAYNE
State : NJ
Zip : 07470-2120
Country : US
Telephone Number : 862-203-1570
Fax Number :
Provider Business Practice Location Address
First Line : 321 HAMBURG TPKE
Second Line :
City : WAYNE
State : NJ
Zip : 07470-2120
Country : US
Telephone Number : 862-203-1570
Fax Number :
Authorized Official
Title or Position : OWNER
Name : JOESEPH MICHAEL CANGIALOSI
Credential : OTD
Telephone Number : 862-203-1570
Provider Enumeration Date : 11/07/2024
Last Update Date : 11/26/2024

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