Provider Demographics
NPI:1467577155
Name:SPORTS CARE AND PHYSICAL REHABILITATION INC.
Entity Type:Organization
Organization Name:SPORTS CARE AND PHYSICAL REHABILITATION INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:L
Authorized Official - Last Name:SINGER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:732-758-0002
Mailing Address - Street 1:116 OCEANPORT AVENUE
Mailing Address - Street 2:
Mailing Address - City:LITTLE SILVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07739
Mailing Address - Country:US
Mailing Address - Phone:732-758-0002
Mailing Address - Fax:732-219-0979
Practice Address - Street 1:116 OCEANPORT AVE
Practice Address - Street 2:
Practice Address - City:LITTLE SILVER
Practice Address - State:NJ
Practice Address - Zip Code:07739-1211
Practice Address - Country:US
Practice Address - Phone:732-758-0002
Practice Address - Fax:732-219-0979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
077936Medicare ID - Type Unspecified