Provider Demographics
NPI:1770830895
Name:AC PHYSICAL THERAPY SERVICES INC D/B/A MED REHAB THERAPY
Entity Type:Organization
Organization Name:AC PHYSICAL THERAPY SERVICES INC D/B/A MED REHAB THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LEE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIZAD
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:609-645-2224
Mailing Address - Street 1:2406 NEW RD
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08225-1409
Mailing Address - Country:US
Mailing Address - Phone:609-645-2225
Mailing Address - Fax:
Practice Address - Street 1:2406 NEW RD
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08225-1409
Practice Address - Country:US
Practice Address - Phone:609-645-2225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-08
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00259200225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty