Provider Demographics
NPI:1528235827
Name:NORTH JERSEY REHABILITATION CENTER P.C.
Entity type:Organization
Organization Name:NORTH JERSEY REHABILITATION CENTER P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:K
Authorized Official - Last Name:YU
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:201-944-5999
Mailing Address - Street 1:120 VAN NOSTRAND AVE
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD CLIFFS
Mailing Address - State:NJ
Mailing Address - Zip Code:07632-1555
Mailing Address - Country:US
Mailing Address - Phone:201-944-5999
Mailing Address - Fax:201-947-3994
Practice Address - Street 1:120 VAN NOSTRAND AVE
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD CLIFFS
Practice Address - State:NJ
Practice Address - Zip Code:07632-1555
Practice Address - Country:US
Practice Address - Phone:201-944-5999
Practice Address - Fax:201-947-3994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-15
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01076000225100000X
NJ38MC00507000111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty