Provider Demographics
NPI:1093201535
Name:REACTION REHAB PHYSICAL THERAPY
Entity Type:Organization
Organization Name:REACTION REHAB PHYSICAL THERAPY
Other - Org Name:REACTION REHAB PHYSICAL THERAPY
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:908-278-9577
Mailing Address - Street 1:67 DONALDSON ST
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08904-2109
Mailing Address - Country:US
Mailing Address - Phone:908-278-9577
Mailing Address - Fax:732-218-8702
Practice Address - Street 1:67 DONALDSON ST
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:08904-2109
Practice Address - Country:US
Practice Address - Phone:908-278-9577
Practice Address - Fax:732-218-8702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-09
Last Update Date:2018-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty