| NPI | 1104554633 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROMAN SHAPOSHNIKOV Owner 732-546-1383 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Enumeration Date | 2022-08-11 |
| Last Update Date | 2025-05-18 |