Provider Demographics
NPI:1710345301
Name:NATIONAL COMPREHENSIVE MEDICAL & REHABILITATION SERVICES, LLC
Entity Type:Organization
Organization Name:NATIONAL COMPREHENSIVE MEDICAL & REHABILITATION SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:K
Authorized Official - Last Name:HYON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:201-819-5702
Mailing Address - Street 1:46 DUKE DR
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-4320
Mailing Address - Country:US
Mailing Address - Phone:201-819-5702
Mailing Address - Fax:
Practice Address - Street 1:46 DUKE DR
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-4320
Practice Address - Country:US
Practice Address - Phone:201-819-5702
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-10
Last Update Date:2017-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0529737Medicaid
NJ485455Medicare PIN
NJ0529737Medicaid