Basic Information
| Provider Information | |||||||||
| NPI: | 1144296880 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ASSOCIATES IN REHABILITATION MEDICINE, PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 95 MOUNT KEMBLE AVE | ||||||||
| Address2: | THEBAUD BUILDING, FOURTH FLOOR | ||||||||
| City: | MORRISTOWN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 079605155 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9732672293 | ||||||||
| FaxNumber: | 9732673144 | ||||||||
| Practice Location | |||||||||
| Address1: | 95 MOUNT KEMBLE AVE | ||||||||
| Address2: | THEBAUD BUILDING, FOURTH FLOOR | ||||||||
| City: | MORRISTOWN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 079605155 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9732672293 | ||||||||
| FaxNumber: | 9732673144 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/23/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | MULFORD | ||||||||
| AuthorizedOfficialFirstName: | GREGORY | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9732672293 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | NJ | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
ID Information
| ID | Type | State | Issuer | Description | 4617509 | 05 | NJ | MEDICAID |