Provider Demographics
NPI:1356668305
Name:MAGNIFICENT HEALTHCARE AND REHAB SERVICES LLC
Entity Type:Organization
Organization Name:MAGNIFICENT HEALTHCARE AND REHAB SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANEGER
Authorized Official - Prefix:
Authorized Official - First Name:ANIL
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-762-8346
Mailing Address - Street 1:1030 SAINT GEORGES AVE # LL3
Mailing Address - Street 2:
Mailing Address - City:AVENEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07001-1390
Mailing Address - Country:US
Mailing Address - Phone:732-762-8346
Mailing Address - Fax:732-750-5550
Practice Address - Street 1:1030 SAINT GEORGES AVE # LL3
Practice Address - Street 2:
Practice Address - City:AVENEL
Practice Address - State:NJ
Practice Address - Zip Code:07001-1390
Practice Address - Country:US
Practice Address - Phone:732-762-8346
Practice Address - Fax:732-750-5550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-30
Last Update Date:2010-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00629500261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation