PEDIATRIC REHABILITATION OF NORTH JERSEY PC (NPI# 1396897773) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396897773 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC REHABILITATION OF NORTH JERSEY PC |
| Practice Address |
309 Black Oak Ridge Rd Wayne NJ 07470-6504 |
| Practice Telephone | 9736281300 |
| Practice Fax Number | 9736280300 |
| Mailing Telephone | 9736281300 |
| Mailing Fax Number | 9736280300 |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2014-03-18 |
| Authorized Official Name | MRS. MARISSA M MUCCIO (PRESIDENT) |
| Authorized Official Telephone | 9736281300 |
| Authorized Official Credential | PT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0401X |
Clinic/Center Specialization: Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
40QA00794200 | NJ | Ambulatory Health Care Facilities |
| Street Address |
309 BLACK OAK RIDGE RD |
| City | WAYNE |
| State | NJ |
| Zip Code | 07470-6504 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336299114 | Faith Elise Bell | Speech-Language Pathologist | 309 Black Oak Ridge Rd, Wayne, NJ 07470-6504 | 2007-01-12 |
| 1528468931 | Rebecca Pacailler | Health Educator | 309 Black Oak Ridge Rd, Wayne, NJ 07470-6504 | 2014-09-04 |
| 1487095402 | Alyson Lio | Speech-Language Pathologist | 309 Black Oak Ridge Rd, Wayne, NJ 07470-6504 | 2013-07-08 |
| 1598043200 | Paula Dianne Emma | Occupational Therapist | 309 Black Oak Ridge Rd, Wayne, NJ 07470-6504 | 2011-07-28 |
| 1558675397 | Marissa L Bush | Physical Therapist | 309 Black Oak Ridge Rd, Wayne, NJ 07470-6504 | 2010-08-04 |
| 1023348554 | Diana Carr | Occupational Therapist | 309 Black Oak Ridge Rd, Wayne, NJ 07470-6504 | 2010-01-06 |
| 1396872297 | Marissa M Muccio | Specialist | 309 Black Oak Ridge Rd, Wayne, NJ 07470-6504 | 2007-02-27 |
| 1871631416 | Martha Bonilla | Physical Therapist | 309 Black Oak Ridge Rd, Wayne, NJ 07470-6504 | 2007-02-04 |
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| 1710524087 | Engel Burman At Wayne, LLC | Assisted Living Facility | 1440 Hamburg Turnpike, Wayne, NJ 07470 | 2019-12-05 |
| 1508412669 | Jessie Diana Dunitz | Technician | 66 Sandra Lane, Wayne, NJ 07470 | 2019-08-14 |
| 1447737234 | Meza Behavioral Health, Inc. | Psychologist | 40 Edgemont Crescent, Wayne, NJ 07470 | 2018-07-24 |
| 1881188076 | Christine Nolan | Occupational Therapist | 1 Pike Drive, Wayne, NJ 07470 | 2018-06-20 |
| 1033612403 | County of Passaic Department of Finance | Skilled Nursing Facility | 305 Oldham Road, Wayne, NJ 07470 | 2018-03-13 |
| 1144739590 | Broadway Respite and Home Care | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 7 Allen Drive, Wayne, NJ 07470 | 2017-09-28 |
| 1679096697 | Wafaa Saad | Counselor | 1009 Valley Rd, Wayne, NJ 07470 | 2017-07-21 |
| 1659803138 | Allison Nicole Diangelo | Nurse Practitioner | 1578 Rte 23, Wayne, NJ 07470 | 2017-04-03 |
| Find all providers in zip 07470 | ||||
| Taxonomy Code | 261QR0401X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649374174 | North Jersey Therapy Center LLC | Clinic/Center | 500 Valley Rd, Suite 101, Wayne, NJ 07470 | 2006-09-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760925085 | Resa Treatment Center | Clinic/Center | 199 Main St Ste 2a, Keansburg, NJ 07734-1768 | 2016-11-19 |
| 1477898096 | Cooperative Care Partnership, Inc | Clinic/Center | 1076 Route 47 S, Rio Grande, NJ 08242-1608 | 2012-12-07 |
| 1881981389 | Well of Hope Community Development Corporation, Inc. | Clinic/Center | 207 Broadway, Paterson, NJ 07501-2002 | 2011-07-05 |
| 1477728285 | Daytop Village of New Jersey, Inc. | Clinic/Center | 6 Gauntt Pl Bldg 2, Flemington, NJ 08822-4614 | 2008-04-23 |
| 1356524912 | Washington Township Corf, LLC | Clinic/Center | 100 Kings Way E Ste B4-6, Sewell, NJ 08080-2237 | 2007-12-06 |
| 1982813531 | Pilgrimage Outreach,inc. ( Fbhsp ) | Clinic/Center | 449 Union Ave, Paterson, NJ 07522-1937 | 2007-05-21 |
| 1386770659 | Dynamic Physical Therapy Center | Clinic/Center | 313 E Westfield Ave, Roselle Park, NJ 07204-2317 | 2007-02-23 |
| 1841307881 | Daytop Village of Nj | Clinic/Center | 6 Gauntt Pl, Bldg #2, Flemington, NJ 08822-4614 | 2006-08-24 |
| 1316944523 | Wellness Center At Hamilton Park | Clinic/Center | 330 9th St, Jersey City, NJ 07302-1561 | 2005-07-01 |
| 1184621484 | Qualcare Therapy Center Inc | Clinic/Center | 2333 Morris Ave, Suite C-3, Union, NJ 07083-5714 | 2005-06-30 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.