Professional Health & Rehabilitation Center

Primary specialty

Rehabilitation ChiropractorTaxonomy code 111NR0400X

Legal business name

PROFESSIONAL HEALTH & REHABILITATION CENTER

Practice address

2683 County Road 516
Old Bridge, NJ 08857-2300

Phone

(732) 607-1133

Fax

(732) 607-1145

NPI assigned

May 7, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Steven Mark, D.C.

Title

Owner

Phone

(732) 607-1133

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124231303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2683 COUNTY ROAD 516",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088572300",
            "telephone_number": "732-607-1133",
            "fax_number": "732-607-1145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2683 COUNTY ROAD 516",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088572300",
            "telephone_number": "732-607-1133",
            "fax_number": "732-607-1145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL HEALTH & REHABILITATION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MARK",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-607-1133",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.