Provider Demographics
NPI:1073984605
Name:EIKEV REHAB LLC
Entity Type:Organization
Organization Name:EIKEV REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHANA
Authorized Official - Middle Name:
Authorized Official - Last Name:POLLAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-439-8641
Mailing Address - Street 1:1539 ROCKAWAY RD
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-3931
Mailing Address - Country:US
Mailing Address - Phone:347-439-8641
Mailing Address - Fax:732-377-5140
Practice Address - Street 1:1539 ROCKAWAY RD
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-3931
Practice Address - Country:US
Practice Address - Phone:347-439-8641
Practice Address - Fax:732-377-5140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-08
Last Update Date:2015-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty