Provider Demographics
NPI:1043459076
Name:ULTIMATE REHAB
Entity Type:Organization
Organization Name:ULTIMATE REHAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGM
Authorized Official - Prefix:
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:LABARBIERA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:201-759-6924
Mailing Address - Street 1:74 OAK ST
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-2557
Mailing Address - Country:US
Mailing Address - Phone:201-759-6924
Mailing Address - Fax:
Practice Address - Street 1:74 OAK ST
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-2557
Practice Address - Country:US
Practice Address - Phone:201-759-6924
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMJDNA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-02-15
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00479500225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty