Provider Demographics
NPI:1972743342
Name:CENTER FOR WELLNESS & REHABILITATION
Entity type:Organization
Organization Name:CENTER FOR WELLNESS & REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:DC, CCSP
Authorized Official - Phone:201-670-7661
Mailing Address - Street 1:251 ROCK RD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:GLEN ROCK
Mailing Address - State:NJ
Mailing Address - Zip Code:07452-1745
Mailing Address - Country:US
Mailing Address - Phone:201-670-7661
Mailing Address - Fax:
Practice Address - Street 1:251 ROCK RD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:GLEN ROCK
Practice Address - State:NJ
Practice Address - Zip Code:07452-1745
Practice Address - Country:US
Practice Address - Phone:201-670-7661
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-25
Last Update Date:2009-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy