Provider Demographics
NPI:1255660031
Name:A M RAFI PC
Entity Type:Organization
Organization Name:A M RAFI PC
Other - Org Name:WADDINGTON REHAB CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARIF
Authorized Official - Middle Name:M
Authorized Official - Last Name:RAFI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-483-4282
Mailing Address - Street 1:100 STOOPS DR
Mailing Address - Street 2:SUITE 240 SPARTAN SURGERY CENTER
Mailing Address - City:MONONGAHELA
Mailing Address - State:PA
Mailing Address - Zip Code:15063-3553
Mailing Address - Country:US
Mailing Address - Phone:724-483-4282
Mailing Address - Fax:724-483-4078
Practice Address - Street 1:100 STOOPS DRIVE
Practice Address - Street 2:SUITE 240 SPARTAN SURGERY CENTER
Practice Address - City:MONONGAHELA
Practice Address - State:PA
Practice Address - Zip Code:15063
Practice Address - Country:US
Practice Address - Phone:724-483-4282
Practice Address - Fax:724-483-4078
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:A M RAFI PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-12-08
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207LA0401X, 261QR0405X
PA433281207LP2900X, 208VP0014X
PA707292324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No207LA0401XAllopathic & Osteopathic PhysiciansAnesthesiologyAddiction MedicineGroup - Multi-Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use DisorderGroup - Multi-Specialty
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilityGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1024590010002Medicaid
PA1024561530001Medicaid
PA1024561530001Medicaid