Provider Demographics
NPI:1639651078
Name:EXCEL HOME REHAB LLC
Entity Type:Organization
Organization Name:EXCEL HOME REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:NINA DULCE
Authorized Official - Middle Name:PINEDA
Authorized Official - Last Name:RAMOS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:732-351-9056
Mailing Address - Street 1:26 JANCI CT
Mailing Address - Street 2:
Mailing Address - City:METUCHEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08840-2914
Mailing Address - Country:US
Mailing Address - Phone:732-351-9056
Mailing Address - Fax:732-362-4967
Practice Address - Street 1:26 JANCI CT
Practice Address - Street 2:
Practice Address - City:METUCHEN
Practice Address - State:NJ
Practice Address - Zip Code:08840-2914
Practice Address - Country:US
Practice Address - Phone:732-351-9056
Practice Address - Fax:732-362-4967
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-02
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01228500225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty