Jerseyrehab

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

25MA05600600 Issued in NJ

Legal business name

JERSEYREHAB

Practice address

495 N 13TH St
Newark, NJ 07107-1317

Phone

(973) 268-1444

Fax

(973) 482-3004

NPI assigned

Mar 8, 2007

Organization subpart

Yes

Parent organization

JERSEYREHABAs reported in NPPES

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

Authorized official

Name

Edwin M Gangemi, MD

Title

MD

Phone

(973) 482-1614

Specialties & licenses 4

Addresses

Other identifiers 4

Tax ID family

Jerseyrehab2 organizations share this tax ID, including this one

Part of

Jerseyrehab

Other organizations with this tax ID 1

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

• Jersey Rehab PA

  • Physical Medicine & Rehabilitation Physician
  • Belleville, NJ
  • NPI 1992836431
  NPD tax ID

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210896000000",
    "number": "1801927397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "234 MOUNT PROSPECT AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071042006",
            "telephone_number": "973-482-1614",
            "fax_number": "973-482-2715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 N 13TH ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071071317",
            "telephone_number": "973-268-1444",
            "fax_number": "973-482-3004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERSEYREHAB",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JERSEYREHAB",
        "enumeration_date": "2007-03-08",
        "last_updated": "2008-05-16",
        "status": "A",
        "authorized_official_last_name": "GANGEMI",
        "authorized_official_first_name": "EDWIN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "973-482-1614",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NJ",
            "license": "25MA05600600",
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NJ",
            "license": "25MA06101800",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "NJ",
            "license": "25MA06101800",
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "NJ",
            "license": "25MA05600600",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR MARINI NPI",
            "identifier": "1184656373",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR GANGEMI NPI",
            "identifier": "1962433524",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7198302",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0037435",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brian Michael Jernick Jr., APN, CRNA
• Jersey Chemists Inc
• Jersey Chemists Inc
• Jersey Construction Business LLC
• Jersey Construction Business LLC
• Jet Dental of New Jersey LLC
• Jewish Renaissance Medical Center, Inc.
• Jewish Renaissance Medical Center, Inc.
• Jewish Renaissance Medical Center, Inc.
• Jey Institute

• Physical Medicine & Rehabilitation Physician in Newark, NJ
• Providers in Newark, NJ by specialty
• Physical Medicine & Rehabilitation Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2008; 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.