Provider Demographics
NPI:1497285217
Name:TRINITY REHAB SOMERSET PA
Entity Type:Organization
Organization Name:TRINITY REHAB SOMERSET PA
Other - Org Name:TRINITY REHAB MARLTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TONYA
Authorized Official - Middle Name:
Authorized Official - Last Name:GAVRIELIDES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-219-5700
Mailing Address - Street 1:751 ROUTE 73 N STE 2
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-3456
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:751 ROUTE 73 N STE 2
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-3456
Practice Address - Country:US
Practice Address - Phone:732-219-5700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRINITY REHAB SOMERSET PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-06-14
Last Update Date:2017-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy