Provider Demographics
NPI:1295920627
Name:CENTER FOR MEDICINE AND REHAB OF RAMSEY
Entity type:Organization
Organization Name:CENTER FOR MEDICINE AND REHAB OF RAMSEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:201-230-5777
Mailing Address - Street 1:2 E BLACKWELL ST STE 14
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07801-4645
Mailing Address - Country:US
Mailing Address - Phone:973-361-3500
Mailing Address - Fax:973-361-1360
Practice Address - Street 1:2 E BLACKWELL ST STE 14
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NJ
Practice Address - Zip Code:07801-4645
Practice Address - Country:US
Practice Address - Phone:973-361-3500
Practice Address - Fax:973-361-1360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-10
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNJ 04592111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU54489Medicare UPIN