University Physician Associates of New Jersey Inc

Organization Active NPI Physical Medicine & Rehabilitation Physician · Newark, NJ

NPI 1407866007 · NPPES record last updated Jul 15, 2021

Key facts

NPI
1407866007
Entity type
Organization (NPI type 2)
Primary specialty
Physical Medicine & Rehabilitation Physician 208100000X
Legal business name
UNIVERSITY PHYSICIAN ASSOCIATES OF NEW JERSEY INC
Practice address
90 Bergen St
Newark, NJ 07103-2425
Phone
(973) 972-2802
NPI assigned
Aug 8, 2006
Organization subpart
No

Authorized official

Name
David Haier
Title
Ceo
Phone
(973) 972-9503

Other NPIs with the same Medicare PAC ID 15

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 17

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 381

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

View all 381

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NJ

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20041122000051 NJ Part B Supplier - Clinic/Group Practice 9830003417 Receives reassigned benefits from 15 practitioners
Practice locations: Newark, NJ; Paramus, NJ

National Provider Directory

Tax ID family
University Rehabilitati (18 organizations share this tax ID)

Locations

90 Bergen St
Ofc CTR7100
Newark, NJ 07103

90 Bergen St
#3300
Newark, NJ 07103
Phone (973) 972-2800

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician
Group: 193400000X SINGLE SPECIALTY GROUP
208100000X Yes

Addresses

Primary practice location

90 Bergen St
Newark, NJ 07103-2425

Mailing address

30 Bergen Street
Admc 12 1205
Newark, NJ 07107-3000
Phone (973) 972-0037

Other identifiers

IdentifierTypeStateIssuer
5311403MedicaidNJ

Other names

  • University Rehabilitation Associates Doing business as

Other providers in Newark, NJ

All providers in Newark, NJ · Physical Medicine & Rehabilitation Physician in New Jersey

Sources for this page

Verify at the official NPI Registry.