Provider Demographics
NPI:1376813956
Name:BODYWORKS REHAB LLC
Entity Type:Organization
Organization Name:BODYWORKS REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:VALENTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLARBA
Authorized Official - Suffix:
Authorized Official - Credentials:PT, CAMT
Authorized Official - Phone:201-334-6991
Mailing Address - Street 1:127 S WASHINGTON AVE
Mailing Address - Street 2:UNIT D
Mailing Address - City:BERGENFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07621-2938
Mailing Address - Country:US
Mailing Address - Phone:201-374-1930
Mailing Address - Fax:201-374-1931
Practice Address - Street 1:127 S WASHINGTON AVE
Practice Address - Street 2:UNIT D
Practice Address - City:BERGENFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07621-2938
Practice Address - Country:US
Practice Address - Phone:201-374-1930
Practice Address - Fax:201-374-1931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-12
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01280500225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty