Provider Demographics
NPI:1144267402
Name:PC REHABILITATION MEDICINE AND PHYSICAL THERAPY, P.A.
Entity type:Organization
Organization Name:PC REHABILITATION MEDICINE AND PHYSICAL THERAPY, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:CAVA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-243-1177
Mailing Address - Street 1:960 PLEASANT VALLEY WAY
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-1803
Mailing Address - Country:US
Mailing Address - Phone:973-243-1177
Mailing Address - Fax:973-243-9077
Practice Address - Street 1:960 PLEASANT VALLEY WAY
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-1803
Practice Address - Country:US
Practice Address - Phone:973-243-1177
Practice Address - Fax:973-243-9077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251E1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistElectrophysiology, ClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJPC788419Medicare ID - Type UnspecifiedGROUP NUMBER