Provider Demographics
NPI:1679019897
Name:JEB REHABILITATION PC
Entity Type:Organization
Organization Name:JEB REHABILITATION PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:BATTIPAGLIA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:908-692-5889
Mailing Address - Street 1:94 BRIDGE PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-1700
Mailing Address - Country:US
Mailing Address - Phone:732-972-5900
Mailing Address - Fax:732-972-3232
Practice Address - Street 1:108 WOODWARD RD
Practice Address - Street 2:
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-4223
Practice Address - Country:US
Practice Address - Phone:732-972-5900
Practice Address - Fax:732-972-3232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-11
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00567900111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty