1730276973 NPI number — REHAB CONNECTION, PC

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 1730276973 NPI number — REHAB CONNECTION, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
REHAB CONNECTION, PC
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:
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:
1730276973
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/21/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
301 CHESTNUT ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HADDONFIELD
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08033-1816
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
50 E GLOUCESTER PIKE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BARRINGTON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08007-1323
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-547-4422
Provider Business Practice Location Address Fax Number:
856-547-0660
Provider Enumeration Date:
10/09/2006

Additional Information

Authorized Official

Authorized Official Last Name:
KNECHT
Authorized Official First Name:
AMY
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
856-547-4422

Provider Taxonomy Codes

  • Taxonomy code: 174400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 796881 . This is a "AMERIHEALTH GROUP #" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 604416 . This is a "AETNA GROUP NUMBER" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0865714000 . This is a "PERSONAL CHOICE GROUP #" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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