Provider Demographics
NPI:1528010915
Name:MONROE PHYSICAL THERAPY & WELLNESS CENTER INC.
Entity Type:Organization
Organization Name:MONROE PHYSICAL THERAPY & WELLNESS CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROZELLA
Authorized Official - Middle Name:R
Authorized Official - Last Name:ABIS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:609-409-8484
Mailing Address - Street 1:1600 PERRINEVILLE ROAD
Mailing Address - Street 2:UNIT 4
Mailing Address - City:MONROE TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08831
Mailing Address - Country:US
Mailing Address - Phone:609-409-8484
Mailing Address - Fax:609-409-8383
Practice Address - Street 1:1600 PERRINEVILLE ROAD
Practice Address - Street 2:UNIT 4
Practice Address - City:MONROE TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08831
Practice Address - Country:US
Practice Address - Phone:609-409-8484
Practice Address - Fax:609-409-8383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2010-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJQA005994225100000X
NJQA005990225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
064503Medicare ID - Type Unspecified