Provider Demographics
NPI:1225513500
Name:PREMIER REHABILITATION CONSULTANTS LLC
Entity Type:Organization
Organization Name:PREMIER REHABILITATION CONSULTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:DAMBECK
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:732-974-8100
Mailing Address - Street 1:700 HIGHWAY 71 STE 2
Mailing Address - Street 2:
Mailing Address - City:SEA GIRT
Mailing Address - State:NJ
Mailing Address - Zip Code:08750-2805
Mailing Address - Country:US
Mailing Address - Phone:732-974-8100
Mailing Address - Fax:
Practice Address - Street 1:700 HIGHWAY 71 STE 2
Practice Address - Street 2:
Practice Address - City:SEA GIRT
Practice Address - State:NJ
Practice Address - Zip Code:08750-2805
Practice Address - Country:US
Practice Address - Phone:732-974-8100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-02
Last Update Date:2018-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty