Provider Demographics
NPI:1871686618
Name:BERGEN REHABILITATION SERVICES INC.
Entity Type:Organization
Organization Name:BERGEN REHABILITATION SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHAHIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:AKBAR
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:201-569-4707
Mailing Address - Street 1:354 ELISA DRIVE
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD CLIFFS
Mailing Address - State:NJ
Mailing Address - Zip Code:07632
Mailing Address - Country:US
Mailing Address - Phone:201-569-4707
Mailing Address - Fax:201-569-0222
Practice Address - Street 1:354 ELISA DRIVE
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD CLIFFS
Practice Address - State:NJ
Practice Address - Zip Code:07632
Practice Address - Country:US
Practice Address - Phone:201-569-4707
Practice Address - Fax:201-569-0222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00283400225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ044298Medicare ID - Type Unspecified