Provider Demographics
NPI:1023434644
Name:MOBILITY CLINIC INC
Entity type:Organization
Organization Name:MOBILITY CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AREA ADMINISTRATIVE/HR MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MALINDA
Authorized Official - Middle Name:J
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:CBCS, CCMA, COF
Authorized Official - Phone:732-734-6562
Mailing Address - Street 1:44 LINCOLN HIGHWAY ROUTE 27
Mailing Address - Street 2:SUITE 200C
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-3978
Mailing Address - Country:US
Mailing Address - Phone:732-662-5700
Mailing Address - Fax:732-662-5699
Practice Address - Street 1:44 LINCOLN HIGHWAY ROUTE 27
Practice Address - Street 2:SUITE 200C
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-3978
Practice Address - Country:US
Practice Address - Phone:732-662-5700
Practice Address - Fax:732-662-5699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-06
Last Update Date:2015-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ45PO00014000335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0417734Medicaid
NJ6945150001Medicare PIN