Provider Demographics
NPI:1003310772
Name:CHERRYWELL REHABILITATION
Entity Type:Organization
Organization Name:CHERRYWELL REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHERIYAN
Authorized Official - Suffix:
Authorized Official - Credentials:MBR
Authorized Official - Phone:973-224-6112
Mailing Address - Street 1:25 GROVE PL
Mailing Address - Street 2:
Mailing Address - City:WHIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07981-1337
Mailing Address - Country:US
Mailing Address - Phone:973-224-6112
Mailing Address - Fax:
Practice Address - Street 1:25 GROVE PL
Practice Address - Street 2:
Practice Address - City:WHIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07981-1337
Practice Address - Country:US
Practice Address - Phone:973-224-6112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-19
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty