Provider Demographics
NPI:1851620181
Name:COMPLETE PHYSICAL MEDICINE & REHABILITATION CARE, PA
Entity Type:Organization
Organization Name:COMPLETE PHYSICAL MEDICINE & REHABILITATION CARE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SIMA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLAIMANZADEH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-656-6079
Mailing Address - Street 1:1 CARLSON RD
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-1701
Mailing Address - Country:US
Mailing Address - Phone:917-656-6079
Mailing Address - Fax:
Practice Address - Street 1:1810 PARK AVE
Practice Address - Street 2:
Practice Address - City:SOUTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07080-5522
Practice Address - Country:US
Practice Address - Phone:908-226-1810
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-16
Last Update Date:2009-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08586600208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty