Provider Demographics
NPI:1154400083
Name:NATURAL MEDICINE & REHABILITATION
Entity type:Organization
Organization Name:NATURAL MEDICINE & REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:ROCHA
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:732-222-7799
Mailing Address - Street 1:10-12 WEST END COURT
Mailing Address - Street 2:
Mailing Address - City:LONG BRANCH
Mailing Address - State:NJ
Mailing Address - Zip Code:07740
Mailing Address - Country:US
Mailing Address - Phone:732-222-7799
Mailing Address - Fax:732-222-7996
Practice Address - Street 1:10 12 WEST END COURT
Practice Address - Street 2:
Practice Address - City:LONG BRANCH
Practice Address - State:NM
Practice Address - Zip Code:07740
Practice Address - Country:US
Practice Address - Phone:732-222-7799
Practice Address - Fax:732-222-7996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01197100225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty