Provider Demographics
NPI:1053992107
Name:RAHWAY OT SPINE HEALTH
Entity type:Organization
Organization Name:RAHWAY OT SPINE HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OSARUMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:IGBINOSUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:848-666-7098
Mailing Address - Street 1:1519 IRVING ST
Mailing Address - Street 2:
Mailing Address - City:RAHWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:07065-4035
Mailing Address - Country:US
Mailing Address - Phone:848-666-7098
Mailing Address - Fax:848-666-7176
Practice Address - Street 1:1519 IRVING ST
Practice Address - Street 2:
Practice Address - City:RAHWAY
Practice Address - State:NJ
Practice Address - Zip Code:07065-4035
Practice Address - Country:US
Practice Address - Phone:848-666-7098
Practice Address - Fax:848-666-7176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-20
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Multi-Specialty