NJ Rehab Pain Clinic PC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01074500 Issued in NJ

Legal business name

NJ REHAB PAIN CLINIC PC

Practice address

845 Broad Ave
Ridgefield, NJ 07657-1002

Phone

(201) 390-3730

NPI assigned

May 16, 2016

Organization subpart

No

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

Authorized official

Name

Dave C Marcon, PT

Title

Owner

Phone

(201) 390-3730

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1463356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463529600000",
    "number": "1164879524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "845 BROAD AVE",
            "city": "RIDGEFIELD",
            "state": "NJ",
            "postal_code": "076571002",
            "telephone_number": "201-390-3730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 BROAD AVE",
            "city": "RIDGEFIELD",
            "state": "NJ",
            "postal_code": "076571002",
            "telephone_number": "201-390-3730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NJ REHAB PAIN CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-16",
        "last_updated": "2016-05-18",
        "status": "A",
        "authorized_official_last_name": "MARCON",
        "authorized_official_first_name": "DAVE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-390-3730",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01074500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Ridgefield, NJ
• Providers in Ridgefield, 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 May 18, 2016; 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.