Provider Demographics
NPI:1003175274
Name:REHABILITATION SERVICES ASSOCIATES LLC
Entity Type:Organization
Organization Name:REHABILITATION SERVICES ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:JACK
Authorized Official - Middle Name:B
Authorized Official - Last Name:KUSHNICK
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:732-254-0772
Mailing Address - Street 1:3 TREMBLAY RD
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-4564
Mailing Address - Country:US
Mailing Address - Phone:732-254-0772
Mailing Address - Fax:732-257-0033
Practice Address - Street 1:3 TREMBLAY RD
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-4564
Practice Address - Country:US
Practice Address - Phone:732-254-0772
Practice Address - Fax:732-257-0033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-09
Last Update Date:2012-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00101400225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty