Provider Demographics
NPI:1164912317
Name:AQUATIC INSTITUTE OF NEW JERSEY LLC
Entity Type:Organization
Organization Name:AQUATIC INSTITUTE OF NEW JERSEY LLC
Other - Org Name:REHAB INSTITUTE OF NEW JERSEY LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HADASSA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSKOVITS
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:732-942-9529
Mailing Address - Street 1:415 ARLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-4868
Mailing Address - Country:US
Mailing Address - Phone:908-415-3857
Mailing Address - Fax:732-942-9529
Practice Address - Street 1:415 ARLINGTON AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-4868
Practice Address - Country:US
Practice Address - Phone:908-415-3857
Practice Address - Fax:732-942-9529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-14
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty