Provider Demographics
NPI:1043591571
Name:S-SQUARED
Entity Type:Organization
Organization Name:S-SQUARED
Other - Org Name:PULSE REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RON
Authorized Official - Middle Name:GLEN
Authorized Official - Last Name:SISCOE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:215-646-6499
Mailing Address - Street 1:1825 LIMEKILN PIKE
Mailing Address - Street 2:
Mailing Address - City:DRESHER
Mailing Address - State:PA
Mailing Address - Zip Code:19025-1739
Mailing Address - Country:US
Mailing Address - Phone:215-646-6400
Mailing Address - Fax:215-646-0650
Practice Address - Street 1:1825 LIMEKILN PIKE
Practice Address - Street 2:
Practice Address - City:DRESHER
Practice Address - State:PA
Practice Address - Zip Code:19025-1739
Practice Address - Country:US
Practice Address - Phone:215-646-6400
Practice Address - Fax:215-646-0650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-29
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT020820225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty