Shea Rehabilitation Services,LLC

Primary specialty

ContractorTaxonomy code 171W00000X

License

40QA00198200 Issued in NJ

Legal business name

SHEA REHABILITATION SERVICES,LLC

Practice address

11 Eric Rd
Fairfield, NJ 07004-2303

Phone

(201) 396-1332

NPI assigned

Mar 4, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Robert Kevin Shea, PT

Title

President

Phone

(201) 396-1332

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1267660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267660800000",
    "number": "1558684654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 ERIC RD",
            "city": "FAIRFIELD",
            "state": "NJ",
            "postal_code": "070042303",
            "telephone_number": "201-396-1332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 ERIC RD",
            "city": "FAIRFIELD",
            "state": "NJ",
            "postal_code": "070042303",
            "telephone_number": "201-396-1332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHEA REHABILITATION SERVICES,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-04",
        "last_updated": "2010-03-04",
        "status": "A",
        "authorized_official_last_name": "SHEA",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "KEVIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-396-1332",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Contractor",
            "state": "NJ",
            "license": "40QA00198200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Contractor in Fairfield, NJ
• Providers in Fairfield, NJ by specialty
• Contractor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2010; 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.