Provider Demographics
NPI:1164572194
Name:MONMOUTH REHAB PROFESSIONALS, INC.
Entity Type:Organization
Organization Name:MONMOUTH REHAB PROFESSIONALS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:PHILIP
Authorized Official - Last Name:PAUL
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:732-972-5565
Mailing Address - Street 1:14 COUNTY ROAD 520
Mailing Address - Street 2:SUITE C
Mailing Address - City:ENGLISHTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-8297
Mailing Address - Country:US
Mailing Address - Phone:732-972-5565
Mailing Address - Fax:732-972-5562
Practice Address - Street 1:14 COUNTY ROAD 520
Practice Address - Street 2:SUITE C
Practice Address - City:ENGLISHTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07726-8297
Practice Address - Country:US
Practice Address - Phone:732-972-5565
Practice Address - Fax:732-972-5562
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2010-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ086180Medicare ID - Type Unspecified