Provider Demographics
NPI:1144761180
Name:ALFA REHABILITATION CENTER LLC
Entity Type:Organization
Organization Name:ALFA REHABILITATION CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARIQ
Authorized Official - Middle Name:MOHAMMED
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-600-9462
Mailing Address - Street 1:201 STRYKERS RD
Mailing Address - Street 2:SUITE 19 #280
Mailing Address - City:PHILLIPSBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08865-5400
Mailing Address - Country:US
Mailing Address - Phone:973-600-9462
Mailing Address - Fax:
Practice Address - Street 1:2 INDUSTRIAL RD
Practice Address - Street 2:STE 3-A
Practice Address - City:ALPHA
Practice Address - State:NJ
Practice Address - Zip Code:08865-4081
Practice Address - Country:US
Practice Address - Phone:973-600-9462
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-09
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07920200208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJH65800Medicare UPIN