Provider Demographics
NPI:1336585694
Name:ORTHOSPINE REHAB PC
Entity Type:Organization
Organization Name:ORTHOSPINE REHAB PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:FERRER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:201-889-8401
Mailing Address - Street 1:150 KANSAS ST STE B
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-4017
Mailing Address - Country:US
Mailing Address - Phone:201-889-8401
Mailing Address - Fax:201-857-4292
Practice Address - Street 1:150 KANSAS ST STE B
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-4017
Practice Address - Country:US
Practice Address - Phone:201-889-8401
Practice Address - Fax:201-857-4292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-14
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJPT40QA01043100225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty