CENTER FOR COGNITIVE REHABILITATION NPI 1184703738

NPI Information

NPI: 1184703738
Provider Name: CENTER FOR COGNITIVE REHABILITATION
Classification: Family Medicine - 207QA0401X
Entity Type: Organization

Specialization: Addiction Medicine

Address:
403 RIVER RD
FAIR HAVEN, NJ
ZIP 07704
Phone: (732) 842-6729
Get Directions

CENTER FOR COGNITIVE REHABILITATION is an addiction medicine family medicine in Fair Haven, NJ. The provider is a family medicine physician who specializes in the diagnosis and treatment of addictions. CENTER FOR COGNITIVE REHABILITATION NPI is 1184703738. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

403 RIVER RD
FAIR HAVEN, NJ
ZIP 07704
Phone: (732) 842-6729
Fax: (732) 842-7901

The provider's authorized official is John Paul Swidryk .
The authorized official title is President Owner and has the following contact phone number (732) 842-6729.

The enumeration date for this NPI number is 11/3/2006 and was last updated on 6/18/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207QA0401X	Family Medicine	Addiction Medicine	MA29119	NEW JERSEY	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	C53069	MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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