Provider Demographics
NPI:1407867872
Name:HUNTERDON PHYSICAL MEDICINE AND REHABILITATION LLC
Entity type:Organization
Organization Name:HUNTERDON PHYSICAL MEDICINE AND REHABILITATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HUA
Authorized Official - Middle Name:
Authorized Official - Last Name:LIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-735-0041
Mailing Address - Street 1:10 FOX CHASE TURN
Mailing Address - Street 2:
Mailing Address - City:PITTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08867-4251
Mailing Address - Country:US
Mailing Address - Phone:908-735-0041
Mailing Address - Fax:
Practice Address - Street 1:10 FOX CHASE TURN
Practice Address - Street 2:
Practice Address - City:PITTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08867-4251
Practice Address - Country:US
Practice Address - Phone:908-735-0041
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2015-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07097600208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1003839770OtherNPI
NJ8356106Medicaid
NJH18237Medicare UPIN
NJ1003839770OtherNPI
NJ038515Medicare ID - Type Unspecified