Provider Demographics
NPI:1003816562
Name:THERAPISTS REHABILITATION GROUP
Entity Type:Organization
Organization Name:THERAPISTS REHABILITATION GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MAGDY
Authorized Official - Middle Name:K
Authorized Official - Last Name:ELTTOUNY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:908-688-2077
Mailing Address - Street 1:2143 MORRIS AVE
Mailing Address - Street 2:#7
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-6036
Mailing Address - Country:US
Mailing Address - Phone:908-688-2077
Mailing Address - Fax:908-810-1789
Practice Address - Street 1:2143 MORRIS AVE
Practice Address - Street 2:#7
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-6036
Practice Address - Country:US
Practice Address - Phone:908-688-2077
Practice Address - Fax:908-810-1789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
078845Medicare ID - Type Unspecified