Provider Demographics
NPI:1407186729
Name:NY REHAB, PAIN MANAGEMENT & MEDICAL SERVICES, P.C.
Entity Type:Organization
Organization Name:NY REHAB, PAIN MANAGEMENT & MEDICAL SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:ZELEFSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FAAPMR
Authorized Official - Phone:516-872-3100
Mailing Address - Street 1:125 N CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-3822
Mailing Address - Country:US
Mailing Address - Phone:516-872-3100
Mailing Address - Fax:516-568-0876
Practice Address - Street 1:125 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-3822
Practice Address - Country:US
Practice Address - Phone:516-872-3100
Practice Address - Fax:516-568-0876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-08
Last Update Date:2010-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009216111N00000X
NY179735208100000X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY6336540001Medicare NSC
07913Medicare PIN