MEDICARE: EWING REHAB 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	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1740708825
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EWING REHAB LLC

Provider Business Mailing Address
First Line	:	80 W UPPER FERRY RD
Second Line	:
City	:	EWING
State	:	NJ
Zip	:	08628-2736
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	80 W UPPER FERRY RD
Second Line	:
City	:	EWING
State	:	NJ
Zip	:	08628-2736
Country	:	US
Telephone Number	:	845-517-2652
Fax Number	:	845-517-2654

Authorized Official
Title or Position	:	MANAGER
Name	:	ALIZA EBSTEIN
Credential	:
Telephone Number	:	845-517-2652

Provider Enumeration Date	:	09/08/2017
Last Update Date	:	09/08/2017

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Directions to “EWING REHAB LLC ” Practice Location

Language	Start Address	Practice Location

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