Provider Demographics
NPI:1205376837
Name:ONSITE REHABILITATION LLC
Entity Type:Organization
Organization Name:ONSITE REHABILITATION LLC
Other - Org Name:GREGORY WADE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:WADE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:973-989-7905
Mailing Address - Street 1:PO BOX 794
Mailing Address - Street 2:
Mailing Address - City:WHARTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07885-0794
Mailing Address - Country:US
Mailing Address - Phone:973-989-7905
Mailing Address - Fax:908-879-0437
Practice Address - Street 1:96 PLEASANT HILL RD
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:NJ
Practice Address - Zip Code:07930-2135
Practice Address - Country:US
Practice Address - Phone:908-879-0960
Practice Address - Fax:908-879-0437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-01
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty