Provider Demographics
NPI:1891055737
Name:JB NURSING AND REHAB SOLUTIONS
Entity Type:Organization
Organization Name:JB NURSING AND REHAB SOLUTIONS
Other - Org Name:HUDSON WELLNESS TWO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:BUCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-788-0477
Mailing Address - Street 1:209 COMLY RD
Mailing Address - Street 2:APT C-14
Mailing Address - City:LINCOLN PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07035-1126
Mailing Address - Country:US
Mailing Address - Phone:630-788-0477
Mailing Address - Fax:
Practice Address - Street 1:7310 BERGENLINE AVE
Practice Address - Street 2:
Practice Address - City:NORTH BERGEN
Practice Address - State:NJ
Practice Address - Zip Code:07047-5437
Practice Address - Country:US
Practice Address - Phone:201-590-9999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JB NURSING AND REHAB SOLUTIONS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-05-25
Last Update Date:2012-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ225100000X
NJ40QA01398200261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Multi-Specialty