Provider Demographics
NPI:1487854097
Name:ONSITEREHAB SERVICES, LLC
Entity Type:Organization
Organization Name:ONSITEREHAB SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GANESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:PERUMAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-757-7589
Mailing Address - Street 1:412 PEBBLE CREEK CT
Mailing Address - Street 2:
Mailing Address - City:PENNINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08534-1945
Mailing Address - Country:US
Mailing Address - Phone:201-757-7589
Mailing Address - Fax:
Practice Address - Street 1:412 PEBBLE CREEK CT
Practice Address - Street 2:
Practice Address - City:PENNINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08534-1945
Practice Address - Country:US
Practice Address - Phone:201-757-7589
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-21
Last Update Date:2007-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00349400235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty