Provider Demographics
NPI:1619214004
Name:AMBIENT REHABILITATION
Entity Type:Organization
Organization Name:AMBIENT REHABILITATION
Other - Org Name:AMBIENT REHABILITATION LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:FLORENCE
Authorized Official - Last Name:DELGADO
Authorized Official - Suffix:
Authorized Official - Credentials:PT DPT
Authorized Official - Phone:732-617-6237
Mailing Address - Street 1:660 TENNENT RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-3163
Mailing Address - Country:US
Mailing Address - Phone:732-617-6237
Mailing Address - Fax:732-617-6239
Practice Address - Street 1:660 TENNENT RD
Practice Address - Street 2:SUITE 107
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-3163
Practice Address - Country:US
Practice Address - Phone:732-617-6237
Practice Address - Fax:732-617-6239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-06
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00968600261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy