Provider Demographics
NPI:1083887632
Name:REHABILITATION MEDICINE ASSOCIATES
Entity Type:Organization
Organization Name:REHABILITATION MEDICINE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:LENORE
Authorized Official - Middle Name:Z
Authorized Official - Last Name:GLADSTONE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-547-8899
Mailing Address - Street 1:3435 DEKALB AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-2301
Mailing Address - Country:US
Mailing Address - Phone:718-547-8899
Mailing Address - Fax:718-547-9553
Practice Address - Street 1:3435 DEKALB AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-2301
Practice Address - Country:US
Practice Address - Phone:718-547-8899
Practice Address - Fax:718-547-9553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-03
Last Update Date:2008-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY100686208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty