Provider Demographics
NPI:1760102420
Name:DYNAMIC REHABILITATION SERVICES LLC
Entity Type:Organization
Organization Name:DYNAMIC REHABILITATION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SONNY
Authorized Official - Middle Name:
Authorized Official - Last Name:DIONISIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-312-8456
Mailing Address - Street 1:16 JOSHUA CT
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-8828
Mailing Address - Country:US
Mailing Address - Phone:732-312-8456
Mailing Address - Fax:
Practice Address - Street 1:16 JOSHUA CT
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:NJ
Practice Address - Zip Code:07731-8828
Practice Address - Country:US
Practice Address - Phone:732-312-8456
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-01
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health