Rafael Haim Srour

Primary specialty

Geriatric Physical TherapistTaxonomy code 2251G0304X

License

40QA02309900 Issued in NJ

Practice address

737 Wertheim PL Unit B
Long Branch, NJ 07740-4913

Phone

(347) 461-4669

NPI assigned

Dec 12, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Stern at Home Physical Therapy PC

  • Physical Medicine & Rehabilitation Physician
  • Pomona, NY
  • NPI 1720563380

  Geriatrics, NJ

  Medicare reassignment NPD

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

{
    "created_epoch": "1733961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1750198958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "737 WERTHEIM PL UNIT B",
            "city": "LONG BRANCH",
            "state": "NJ",
            "postal_code": "077404913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "737 WERTHEIM PL UNIT B",
            "city": "LONG BRANCH",
            "state": "NJ",
            "postal_code": "077404913",
            "telephone_number": "347-461-4669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SROUR",
        "first_name": "RAFAEL",
        "middle_name": "HAIM",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-12-12",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "NJ",
            "license": "40QA02309900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gilbert Solitare, M.D.
• Darryl K Speights, MBA
• Charles Louis Spellman, DO
• Suzanne Spernal, APN
• Joshua Lyn Spruell, MD
• Leanna St. Arnauld, OTR
• Annmarie Kate Stango, MS, RDN
• Kathleen Stanier, NP
• Kathleen M Stansfield, RD
• Leah Neal Steinberg, DO

• Geriatric Physical Therapist in Long Branch, NJ
• Providers in Long Branch, NJ by specialty
• Geriatric Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.