Provider Demographics
NPI:1992724918
Name:REHAB AND FITNESS CONSULTING, INC.
Entity type:Organization
Organization Name:REHAB AND FITNESS CONSULTING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF REHABILITATION SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:IRMA
Authorized Official - Middle Name:
Authorized Official - Last Name:TETRUASHVILY
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:856-231-0088
Mailing Address - Street 1:122 E KINGS HWY
Mailing Address - Street 2:SUITE 502
Mailing Address - City:MAPLE SHADE
Mailing Address - State:NJ
Mailing Address - Zip Code:08052-3424
Mailing Address - Country:US
Mailing Address - Phone:856-231-0088
Mailing Address - Fax:856-778-2782
Practice Address - Street 1:122 E KINGS HWY
Practice Address - Street 2:SUITE 502
Practice Address - City:MAPLE SHADE
Practice Address - State:NJ
Practice Address - Zip Code:08052-3424
Practice Address - Country:US
Practice Address - Phone:856-231-0088
Practice Address - Fax:856-778-2782
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00988600225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty