Provider Demographics
NPI:1376668608
Name:WESTERN PENNSYLVANIA REHAB ASSOCIATES,LTD
Entity Type:Organization
Organization Name:WESTERN PENNSYLVANIA REHAB ASSOCIATES,LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:DIMAURO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-941-8702
Mailing Address - Street 1:159 WATERDAM RD
Mailing Address - Street 2:SUITE 240
Mailing Address - City:MC MURRAY
Mailing Address - State:PA
Mailing Address - Zip Code:15317-2576
Mailing Address - Country:US
Mailing Address - Phone:724-941-8702
Mailing Address - Fax:724-941-9089
Practice Address - Street 1:159 WATERDAM RD
Practice Address - Street 2:SUITE 240
Practice Address - City:MC MURRAY
Practice Address - State:PA
Practice Address - Zip Code:15317-2576
Practice Address - Country:US
Practice Address - Phone:724-941-8702
Practice Address - Fax:724-941-9089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD037589E225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011527870003Medicaid
OH9370571Medicare PIN
PA529134Medicare ID - Type UnspecifiedMEDICARE PROV NUMBER
PA0011527870003Medicaid