Provider Demographics
NPI:1679520480
Name:CENTRAL JERSEY REHABILITATION MEDICINE, LLC
Entity type:Organization
Organization Name:CENTRAL JERSEY REHABILITATION MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:J
Authorized Official - Last Name:COOPERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-852-5542
Mailing Address - Street 1:8 S MAIN ST UNIT 226
Mailing Address - Street 2:
Mailing Address - City:MARLBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:07746-8009
Mailing Address - Country:US
Mailing Address - Phone:732-852-5542
Mailing Address - Fax:732-631-8324
Practice Address - Street 1:55 SCHANCK RD STE A-6
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-2963
Practice Address - Country:US
Practice Address - Phone:732-852-5542
Practice Address - Fax:732-631-8324
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty