Integrative Rehabilitation Associates LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

25MB09133500 Issued in NJ

Legal business name

INTEGRATIVE REHABILITATION ASSOCIATES LLC

Practice address

155 Hazel St
Clifton, NJ 07011-3423

Phone

(973) 253-5255

NPI assigned

Jan 20, 2015

Organization subpart

No

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

Authorized official

Name

Melissa Rusli, DO

Title

Owner

Phone

(732) 266-7963

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1421712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467676800000",
    "number": "1366831984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 E MAIN ST",
            "address_2": "SUITE 109",
            "city": "RAMSEY",
            "state": "NJ",
            "postal_code": "074461925",
            "telephone_number": "732-266-7963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 HAZEL ST",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070113423",
            "telephone_number": "973-253-5255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATIVE REHABILITATION ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-20",
        "last_updated": "2016-07-05",
        "status": "A",
        "authorized_official_last_name": "RUSLI",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-266-7963",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MB09133500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "25MB09133500",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Clifton, NJ
• Providers in Clifton, NJ by specialty
• Specialist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 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.