1497754006 NPI number — THE REHABILITATION HOSPITAL AT RARITAN BAY MEDICAL CENTER, LLC

Table of content: SOPHIA SAMDANI KHAN M.D. (NPI 1982847562)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497754006 NPI number — THE REHABILITATION HOSPITAL AT RARITAN BAY MEDICAL CENTER, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE REHABILITATION HOSPITAL AT RARITAN BAY MEDICAL CENTER, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1497754006
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/19/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
530 NEW BRUNSWICK AVENUE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PERTH AMBOY
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08861
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-324-6095
Provider Business Mailing Address Fax Number:
732-324-6091

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
225 WILLIAMSON ST, 7 NORTH
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELIZABETH
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07202-3625
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
908-994-5288
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/15/2005

Additional Information

Authorized Official

Authorized Official Last Name:
LUGO
Authorized Official First Name:
A.
Authorized Official Middle Name:
ALBERTO
Authorized Official Title or Position:
EXECUTIVE VP & GENERAL COUNSEL
Authorized Official Telephone Number:
201-242-4000

Provider Taxonomy Codes

  • Taxonomy code: 282E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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