Provider Demographics
NPI:1821396441
Name:RAISING THE BAR REHABILITATION AND FITNESS LLC
Entity Type:Organization
Organization Name:RAISING THE BAR REHABILITATION AND FITNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:M
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:201-893-5241
Mailing Address - Street 1:201 UNION AVE
Mailing Address - Street 2:
Mailing Address - City:WOOD RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07075-1906
Mailing Address - Country:US
Mailing Address - Phone:201-893-5241
Mailing Address - Fax:201-438-2661
Practice Address - Street 1:341 RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:EAST RUTHERFORD
Practice Address - State:NJ
Practice Address - Zip Code:07073-1717
Practice Address - Country:US
Practice Address - Phone:201-438-7189
Practice Address - Fax:201-438-2661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-06
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00783300225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ231095Medicare PIN