Innovative Physical Rehab and Wellness Center

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

INNOVATIVE PHYSICAL REHAB AND WELLNESS CENTER

Practice address

2204 Route 18 North
Old Bridge, NJ 08857

Phone

(732) 317-4105

NPI assigned

Apr 28, 2021

Organization subpart

No

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

Authorized official

Name

Denise Tavares

Title

Billing Manager

Phone

(732) 317-4105

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1619568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631145600000",
    "number": "1447833421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2204 ROUTE 18 NORTH",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088572758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2204 ROUTE 18 NORTH",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "08857",
            "telephone_number": "732-317-4105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE PHYSICAL REHAB AND WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-28",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A",
        "authorized_official_last_name": "TAVARES",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "732-317-4105"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katerina Iannacone, PT, DPT
• Hellen Ibrahim, PA-C
• Lilian Akinyi Ilamahana, NURSE PRACTITIONER
• Innerspace Counseling, LLC
• Innovative Jogo Physical Therapy
• Inspire Pelvic Rehab LLC
• Instep Podiatry
• Irina Sokolinskaya Apn PC (Quality Healthcare & Wellness Center)
• Island Heights Pediatrics
• Eugene A Isola III, DDS

• Chiropractor in Old Bridge, NJ
• Providers in Old Bridge, NJ by specialty
• Chiropractor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2021; 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.