Provider Demographics
NPI:1003041047
Name:RELIANCE MEDICAL REHABILITATION, LLC
Entity Type:Organization
Organization Name:RELIANCE MEDICAL REHABILITATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:RAYMOND
Authorized Official - Last Name:DAMADIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-454-0700
Mailing Address - Street 1:125 NEWTOWN RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-4314
Mailing Address - Country:US
Mailing Address - Phone:516-454-0700
Mailing Address - Fax:
Practice Address - Street 1:3963-3965 JOG ROAD
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-0000
Practice Address - Country:US
Practice Address - Phone:877-225-5876
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-20
Last Update Date:2009-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty