Provider Demographics
NPI:1306974472
Name:CAMBRIDGE REHABILITATION SERVICES, INC.
Entity type:Organization
Organization Name:CAMBRIDGE REHABILITATION SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:FILIPPONE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:201-251-8555
Mailing Address - Street 1:PO BOX 325
Mailing Address - Street 2:
Mailing Address - City:HO HO KUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07423-0325
Mailing Address - Country:US
Mailing Address - Phone:201-251-8555
Mailing Address - Fax:201-251-9595
Practice Address - Street 1:31 SHERIDAN AVE
Practice Address - Street 2:
Practice Address - City:HO HO KUS
Practice Address - State:NJ
Practice Address - Zip Code:07423-1572
Practice Address - Country:US
Practice Address - Phone:201-251-8555
Practice Address - Fax:201-251-9595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7712006Medicaid