Provider Demographics
NPI:1427587500
Name:ONE WELLNESS & REHABILITATION LLC
Entity Type:Organization
Organization Name:ONE WELLNESS & REHABILITATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PT
Authorized Official - Prefix:
Authorized Official - First Name:REEMA
Authorized Official - Middle Name:
Authorized Official - Last Name:THAKKAR
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:732-826-1732
Mailing Address - Street 1:25 MAIN ST STE 12
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08837-3448
Mailing Address - Country:US
Mailing Address - Phone:732-826-1732
Mailing Address - Fax:
Practice Address - Street 1:25 MAIN ST STE 12
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08837-3448
Practice Address - Country:US
Practice Address - Phone:732-826-1732
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-12
Last Update Date:2017-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01596700225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty