Provider Demographics
NPI:1164547113
Name:REHABMAX PHYSICAL THERAPY PA
Entity Type:Organization
Organization Name:REHABMAX PHYSICAL THERAPY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAROSLAW
Authorized Official - Middle Name:
Authorized Official - Last Name:CZAJKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:908-241-4390
Mailing Address - Street 1:329 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:ROSELLE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07204-1948
Mailing Address - Country:US
Mailing Address - Phone:908-241-4390
Mailing Address - Fax:908-245-4905
Practice Address - Street 1:329 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:ROSELLE PARK
Practice Address - State:NJ
Practice Address - Zip Code:07204-1948
Practice Address - Country:US
Practice Address - Phone:908-241-4390
Practice Address - Fax:908-245-4905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty