Provider Demographics
NPI:1528580925
Name:TRINITY REHAB SOMERSET PA
Entity Type:Organization
Organization Name:TRINITY REHAB SOMERSET PA
Other - Org Name:TRINITY REHAB MIDDLETOWN
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 1:328 NEWMAN SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-5654
Mailing Address - Country:US
Mailing Address - Phone:732-219-5700
Mailing Address - Fax:732-334-3003
Practice Address - Street 1:470 HIGHWAY 35
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-5038
Practice Address - Country:US
Practice Address - Phone:732-219-5700
Practice Address - Fax:732-334-3003
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRINITY REHAB SOMERSET PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-07-07
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1245789064OtherBCBS