Provider Demographics
NPI:1225140387
Name:GENERAL MEDICAL & REHABILITATION ASSOCIATES, INC
Entity Type:Organization
Organization Name:GENERAL MEDICAL & REHABILITATION ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BORIS
Authorized Official - Middle Name:
Authorized Official - Last Name:NEMIROVSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-698-2220
Mailing Address - Street 1:9551 BUSTLETON AVENUE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19115-3800
Mailing Address - Country:US
Mailing Address - Phone:215-698-2220
Mailing Address - Fax:215-464-1808
Practice Address - Street 1:9551 BUSTLETON AVENUE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19115-3800
Practice Address - Country:US
Practice Address - Phone:215-698-2220
Practice Address - Fax:215-464-1808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0058439000OtherKHPE KH65 AMERIHEALTH HMO
PA0567260001OtherMEDICARE DME
PA1013277410001Medicaid
P11221508OtherMULTIPLAN HEALTH EOS
PA5444501OtherAETNA PPO
98916OtherHIGHMARCK BCBS PIN
2374620000OtherKHPE KH65 AMERIHEALTH HMO
1048941OtherKEYSTONE MERCY
1013277410001OtherDPA GROUP
249697OtherHEALTH NET
98916OtherHORIZON
P2784771OtherOXFORD HEALTH PLAN
0100059801OtherAMERICHOICE
098916T50OtherMEDICARE PIN
0010005980001OtherDPA
PA0876682OtherAETNA HMO
PA1702545OtherHIGHMARCK BCBS
0100059801OtherAMERICHOICE
249697OtherHEALTH NET
249697OtherHEALTH NET
098916T50Medicare UPIN