Provider Demographics
NPI:1093216947
Name:EDISON HEALTH AND REHABILITATION
Entity Type:Organization
Organization Name:EDISON HEALTH AND REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HANDLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:845-598-8137
Mailing Address - Street 1:PO BOX 704
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-0704
Mailing Address - Country:US
Mailing Address - Phone:732-630-8949
Mailing Address - Fax:
Practice Address - Street 1:191 TALMADGE RD
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08817-2848
Practice Address - Country:US
Practice Address - Phone:732-630-8949
Practice Address - Fax:732-630-8949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-26
Last Update Date:2018-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00730300111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty