Provider Demographics
NPI:1255970216
Name:ALLURE REHAB LLC
Entity type:Organization
Organization Name:ALLURE REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHEB
Authorized Official - Middle Name:S
Authorized Official - Last Name:BOTROTH
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:347-459-6778
Mailing Address - Street 1:71 BALTUSROL RD
Mailing Address - Street 2:
Mailing Address - City:SUMMIT
Mailing Address - State:NJ
Mailing Address - Zip Code:07901-3306
Mailing Address - Country:US
Mailing Address - Phone:347-459-6778
Mailing Address - Fax:201-494-2788
Practice Address - Street 1:71 BALTUSROL RD
Practice Address - Street 2:
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-3306
Practice Address - Country:US
Practice Address - Phone:347-459-6778
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-22
Last Update Date:2019-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy