| Organization Name: | CENTER FOR COGNITIVE REHABILITATION |
| NPI Number: | 1184703738 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOHN PAUL SWIDRYK (PRESIDENT OWNER) |
| Mailing Address: | 403 River Rd Fair Haven |
| State: | NJ US |
| Postal Code: | 07704 |
| Phone Number: | 7328426729 |
| Fax Number: | 7328427901 |
| NPI Enumeration Date: | 11/03/2006 |
| NPI Last Update Date: | 06/18/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207QA0401X |
| License Number: | MA29119 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Family Medicine |
| Taxonomy Specialization: | Addiction Medicine |
| Taxonomy Definition: | A family medicine physician who specializes in the diagnosis and treatment of addictions. |