Provider Demographics
NPI:1013008580
Name:PHYSICAL MEDICINE AND REHABILITATION SVCS OF HUDSON COUNTYP.A
Entity Type:Organization
Organization Name:PHYSICAL MEDICINE AND REHABILITATION SVCS OF HUDSON COUNTYP.A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:MEHTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-656-3647
Mailing Address - Street 1:142 PALISADE AVE
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-1133
Mailing Address - Country:US
Mailing Address - Phone:201-656-3647
Mailing Address - Fax:
Practice Address - Street 1:142 PALISADE AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-1133
Practice Address - Country:US
Practice Address - Phone:201-656-3647
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ33984171100000X, 173000000X, 174400000X, 1744P3200X, 204C00000X, 204D00000X, 225100000X, 2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Not Answered173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty
Not Answered174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Not Answered1744P3200XOther Service ProvidersSpecialistProsthetics Case ManagementGroup - Single Specialty
Not Answered204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports MedicineGroup - Single Specialty
Not Answered204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Single Specialty
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Not Answered2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJDO6820Medicare UPIN
NJME521009Medicare ID - Type Unspecified