Provider Demographics
NPI:1336691526
Name:ROMANDETTI REHABILITATION SERVICES, LLC
Entity Type:Organization
Organization Name:ROMANDETTI REHABILITATION SERVICES, LLC
Other - Org Name:EMPORIA PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICAL THERAPIST/CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ANGELO
Authorized Official - Last Name:ROMANDETTI
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:845-224-5261
Mailing Address - Street 1:317 N MAIN ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:EMPORIA
Mailing Address - State:VA
Mailing Address - Zip Code:23847-1607
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:317 N MAIN ST
Practice Address - Street 2:SUITE C
Practice Address - City:EMPORIA
Practice Address - State:VA
Practice Address - Zip Code:23847-1607
Practice Address - Country:US
Practice Address - Phone:845-224-5261
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-04
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305208064225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty