Provider Demographics
NPI:1225242738
Name:HAND SURGICAL & REHABILITATION ASSOC., INC.
Entity Type:Organization
Organization Name:HAND SURGICAL & REHABILITATION ASSOC., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:NISSENBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-947-3606
Mailing Address - Street 1:1841 HUNTINGDON PIKE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-7712
Mailing Address - Country:US
Mailing Address - Phone:215-947-3606
Mailing Address - Fax:215-947-6901
Practice Address - Street 1:1841 HUNTINGDON PIKE
Practice Address - Street 2:
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-7712
Practice Address - Country:US
Practice Address - Phone:215-947-3606
Practice Address - Fax:215-947-6901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD012063E2086S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the HandGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1326046103OtherNPI FOR INDIVIDUAL
1326046103OtherNPI FOR INDIVIDUAL
PA039476Medicare ID - Type Unspecified
PA0762130002Medicare NSC