Pristine Rehabilitation

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PRISTINE REHABILITATION

Practice address

184 Burns Way
Fanwood, NJ 07023-1604

Phone

(617) 686-9000

NPI assigned

Oct 3, 2018

Organization subpart

No

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

Authorized official

Name

Ronald CasanovaNPI 1962532291

Title

Owner

Phone

(617) 686-9000

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ronald Casanova, MSPT

  • Physical Therapist
  • Bridgewater, NJ
  • NPI 1962532291
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1538524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538524800000",
    "number": "1124593389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "184 BURNS WAY",
            "city": "FANWOOD",
            "state": "NJ",
            "postal_code": "070231604",
            "telephone_number": "617-686-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "184 BURNS WAY",
            "city": "FANWOOD",
            "state": "NJ",
            "postal_code": "070231604",
            "telephone_number": "617-686-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRISTINE REHABILITATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-03",
        "last_updated": "2018-10-03",
        "status": "A",
        "authorized_official_last_name": "CASANOVA",
        "authorized_official_first_name": "RONALD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-686-9000"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Ann Perez, PMHNP
• Deborah Petitjean, MS PT
• Vincenza Piscitelli, PSYD
• Roseann Pizzi, PSYD
• Primary Care Partners, LLC
• Cynthia Ann Puchammer, MSW, LCSW
• Caroline Raba, LPC
• Rabbinic Center for Research and Counseling
• Lisa Ann Radil
• Lila K Redmount, MSW, LCSW

• Physical Therapist in Fanwood, NJ
• Providers in Fanwood, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.