Provider Demographics
NPI:1275986515
Name:LGM REHAB SERVICES, LLC
Entity Type:Organization
Organization Name:LGM REHAB SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REHAB MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GERALDINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARAPAO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:973-931-0797
Mailing Address - Street 1:10 FARM VIEW CT
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-2535
Mailing Address - Country:US
Mailing Address - Phone:973-931-0797
Mailing Address - Fax:
Practice Address - Street 1:10 FARM VIEW CT
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2535
Practice Address - Country:US
Practice Address - Phone:973-931-0797
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-21
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA009669261QP2000X, 261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy