Provider Demographics
NPI:1346490257
Name:KING REHAB SERVICES COMPANY
Entity Type:Organization
Organization Name:KING REHAB SERVICES COMPANY
Other - Org Name:KING REHAB CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:732-608-0147
Mailing Address - Street 1:751 ROUTE 37 W
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-5032
Mailing Address - Country:US
Mailing Address - Phone:732-608-0147
Mailing Address - Fax:732-353-5123
Practice Address - Street 1:751 ROUTE 37 W
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-5032
Practice Address - Country:US
Practice Address - Phone:732-608-0147
Practice Address - Fax:732-353-5123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-27
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJPT40QA0931200261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ156156OtherMEDICARE PTAN