Provider Demographics
NPI:1467889600
Name:REHAB AT HOME
Entity Type:Organization
Organization Name:REHAB AT HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DIGREGORIO
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:347-351-7103
Mailing Address - Street 1:872 WINYAH AVE
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090-1941
Mailing Address - Country:US
Mailing Address - Phone:347-351-7103
Mailing Address - Fax:
Practice Address - Street 1:872 WINYAH AVE
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-1941
Practice Address - Country:US
Practice Address - Phone:347-351-7103
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-02
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018882225100000X
NJ40QA01232200225100000X
NJ46TR00330600225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ173987Medicare UPIN
NYQH4631Medicare UPIN