Provider Demographics
NPI:1497462808
Name:MOBILITY CLINIC INC
Entity Type:Organization
Organization Name:MOBILITY CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO, CPO, LPO
Authorized Official - Prefix:
Authorized Official - First Name:RAKESH
Authorized Official - Middle Name:
Authorized Official - Last Name:JAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-774-1085
Mailing Address - Street 1:60 LINCOLN HIGHWAY STE A.
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820
Mailing Address - Country:US
Mailing Address - Phone:732-662-5700
Mailing Address - Fax:732-662-5699
Practice Address - Street 1:60 LINCOLN HIGHWAY STE A
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820
Practice Address - Country:US
Practice Address - Phone:732-662-5700
Practice Address - Fax:732-662-5699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-04
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ041774Medicaid