Provider Demographics
NPI:1730758988
Name:CAREMAX FOR PHYSICAL THERAPY AND REHABILITATION SERVICES LLC
Entity type:Organization
Organization Name:CAREMAX FOR PHYSICAL THERAPY AND REHABILITATION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MAGDOLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHENOUDA
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, PHD
Authorized Official - Phone:201-380-6385
Mailing Address - Street 1:317 AVENUE C
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-1400
Mailing Address - Country:US
Mailing Address - Phone:201-932-5820
Mailing Address - Fax:201-455-2365
Practice Address - Street 1:317 AVENUE C
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-1400
Practice Address - Country:US
Practice Address - Phone:201-932-5820
Practice Address - Fax:201-455-2365
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-22
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy