Provider Demographics
NPI:1528480266
Name:PHYSICAL MEDICINE & REHAB LLC
Entity type:Organization
Organization Name:PHYSICAL MEDICINE & REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:HOROWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:732-780-2273
Mailing Address - Street 1:103 PROFESSIONAL VIEW DR
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-7902
Mailing Address - Country:US
Mailing Address - Phone:732-780-2273
Mailing Address - Fax:732-780-3752
Practice Address - Street 1:103 PROFESSIONAL VIEW DR
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-7902
Practice Address - Country:US
Practice Address - Phone:732-780-2273
Practice Address - Fax:732-780-3752
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-15
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00059300171100000X
NJ40QA01422300225100000X
NJ38MC00556200111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty