Provider Demographics
NPI:1396779559
Name:R & R REHABILITATION AND PHYSICAL THERAPY, LLC
Entity type:Organization
Organization Name:R & R REHABILITATION AND PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUMMER
Authorized Official - Suffix:
Authorized Official - Credentials:PHYSICAL THERAPIST
Authorized Official - Phone:201-265-1500
Mailing Address - Street 1:1 ELDEN DR
Mailing Address - Street 2:
Mailing Address - City:SADDLE RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07458-2809
Mailing Address - Country:US
Mailing Address - Phone:201-265-1500
Mailing Address - Fax:201-265-3040
Practice Address - Street 1:1 SEARS DR
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-3515
Practice Address - Country:US
Practice Address - Phone:201-265-1500
Practice Address - Fax:201-265-3040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2010-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00661200261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ=========AOtherBLUE CROSS BLUE SHIELD
NJ=========AOtherBLUE CROSS BLUE SHIELD
NJ104672Medicare PIN