OrganizationActive
Pediatric Rehabilitation Associates, LLC
NPI 1558811372 · Pediatric Rehabilitation Medicine Physician · Marlton, NJ
Provider details
- NPI number
- 1558811372
- Entity type
- Organization
- Primary specialty
- Pediatric Rehabilitation Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Connie Domingo, President(609) 410-8055
- License
- 25MA06376400 (NJ)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(71/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
92 Brick Rd Fl 3
Marlton, NJ 08053-2177
Phone: (856) 489-4520
Street-level locationGet directions
Mailing address
Po Box 674
Marlton, NJ 08053-0674
Registry dates
- Enumerated
- 2016-10-04
- Last updated
- 2017-02-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.