1083753727 NPI number — CENTER FOR VOCATIONAL REHAB

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083753727 NPI number — CENTER FOR VOCATIONAL REHAB

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CENTER FOR VOCATIONAL REHAB
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:
MONMOUTH CTR FOR VOC REHAB
Provider Other Organization Name Type Code:
4
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:
1083753727
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
15 MERIDIAN RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EATONTOWN
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07724-2242
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-544-1800
Provider Business Mailing Address Fax Number:
732-389-3453

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1451 ROUTE 37 W
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TOMS RIVER
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08755-4969
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-244-7511
Provider Business Practice Location Address Fax Number:
732-244-7553
Provider Enumeration Date:
02/06/2007

Additional Information

Authorized Official

Authorized Official Last Name:
COSENZA
Authorized Official First Name:
KAREN
Authorized Official Middle Name:
Authorized Official Title or Position:
VP CONTROLLER
Authorized Official Telephone Number:
732-544-1800

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 7642300 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".




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