Provider Demographics
NPI:1639762024
Name:HEALTHSPAN HEALTHCARE SERVICES LLC
Entity Type:Organization
Organization Name:HEALTHSPAN HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHENG-TUNG
Authorized Official - Middle Name:
Authorized Official - Last Name:KU
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:973-462-6435
Mailing Address - Street 1:34 CEDAR BROOK DR
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-2854
Mailing Address - Country:US
Mailing Address - Phone:973-462-6435
Mailing Address - Fax:973-486-6748
Practice Address - Street 1:34 CEDAR BROOK DR
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-2854
Practice Address - Country:US
Practice Address - Phone:973-462-6435
Practice Address - Fax:973-486-6748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-16
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty