Provider Demographics
NPI:1619322013
Name:LEADING REHABILITATION
Entity Type:Organization
Organization Name:LEADING REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:AVNEE
Authorized Official - Middle Name:MAGANLAL
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:732-306-9201
Mailing Address - Street 1:44 BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:METUCHEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08840-2278
Mailing Address - Country:US
Mailing Address - Phone:326-662-1800
Mailing Address - Fax:732-662-1801
Practice Address - Street 1:33 CLARENDON CT
Practice Address - Street 2:
Practice Address - City:METUCHEN
Practice Address - State:NJ
Practice Address - Zip Code:08840-1504
Practice Address - Country:US
Practice Address - Phone:732-306-9201
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-04
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJPTQA00948200261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center