Jersey Rehab PA

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

25MA05600600 Issued in NJ

Legal business name

JERSEY REHAB PA

Practice address

77 Newark Ave
Belleville, NJ 07109-4143

Phone

(973) 844-9220

Fax

(973) 844-9221

NPI assigned

Mar 8, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Edwin M Gangemi, MD

Title

Credentialing

Phone

(973) 482-1614

Specialties & licenses 4

Addresses

Other identifiers 4

Other names 1

• Westchester Rehabilitation Other name

Tax ID family

Jersey Rehab PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Jerseyrehab

  • Physical Medicine & Rehabilitation Physician
  • Newark, NJ
  • NPI 1801927397
  NPD tax ID

Locations

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193875200000",
    "number": "1992836431",
    "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": "973-485-6126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 NEWARK AVE",
            "city": "BELLEVILLE",
            "state": "NJ",
            "postal_code": "071094143",
            "telephone_number": "973-844-9220",
            "fax_number": "973-844-9221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERSEY REHAB PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2007-11-01",
        "status": "A",
        "authorized_official_last_name": "GANGEMI",
        "authorized_official_first_name": "EDWIN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "973-482-1614",
        "authorized_official_name_prefix": "Dr.",
        "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": "0037435",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7198302",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Westchester Rehabilitation",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Roy Anthony Ngpit Javier, CRNA
• Betsy Jean-Louis, FNP-BC, APN-C
• Dania Jean-Louis, APN
• Jerrold T. Jacob D.M.D., P.a. (Family Dental Group)
• Jersey Rehab PA
• Joel John
• Donya Paulette Johnson, LPC
• Lisa M. Johnson, L.C.S.W.
• Jean-Ronald Joseph, PTA
• Journey Therapy Center

• Physical Medicine & Rehabilitation Physician in Belleville, NJ
• Providers in Belleville, 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 Nov 1, 2007; 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.