Basic Information
| Provider Information | |||||||||
| NPI: | 1396276390 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | DYNAMIC CARE AND REHABILITATION CENTER LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4581 ROUTE 9 N | ||||||||
| Address2: | STE 100 | ||||||||
| City: | HOWELL | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 077313382 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2016351195 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4581 ROUTE 9 N | ||||||||
| Address2: | STE 100 | ||||||||
| City: | HOWELL | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 077313382 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2016351195 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/22/2017 | ||||||||
| LastUpdateDate: | 03/22/2017 | ||||||||
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| AuthorizedOfficialLastName: | JAFFA | ||||||||
| AuthorizedOfficialFirstName: | JACK | ||||||||
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| AuthorizedOfficialTitleorPosition: | MEMBER | ||||||||
| AuthorizedOfficialTelephone: | 2016351195 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR0400X | Y | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation |
No ID Information.