Provider Demographics
NPI:1487186193
Name:TRINITY REHAB SOMERSET PA
Entity Type:Organization
Organization Name:TRINITY REHAB SOMERSET PA
Other - Org Name:TRINITY REHAB SOMERVILLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:RIZKALLA
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L, MLDT
Authorized Official - Phone:732-219-5700
Mailing Address - Street 1:554 HIGHWAY 35
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-5066
Mailing Address - Country:US
Mailing Address - Phone:732-219-5700
Mailing Address - Fax:732-334-3003
Practice Address - Street 1:89 ROUTE 206
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08876-4102
Practice Address - Country:US
Practice Address - Phone:908-393-2180
Practice Address - Fax:908-800-0500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-31
Last Update Date:2017-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty