Provider Demographics
NPI:1508040650
Name:DR. MA'S MEDICAL REHAB., P.C.
Entity Type:Organization
Organization Name:DR. MA'S MEDICAL REHAB., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KEYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-888-1513
Mailing Address - Street 1:41 ROBERT CIR
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-3829
Mailing Address - Country:US
Mailing Address - Phone:516-558-7886
Mailing Address - Fax:
Practice Address - Street 1:13620 38 AVE
Practice Address - Street 2:6M
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354
Practice Address - Country:US
Practice Address - Phone:718-888-1513
Practice Address - Fax:718-514-7031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-26
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2269712081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY226971-OWOtherWORKERS' COMPENSATION
NY394671POtherHIP
0175J3OtherEMPIRE BCBS
NY184624OtherELDER PLAN
NY05619OtherGHI-MEDICARE
NY2285217OtherUNITED HEALTHCARE
NY10742714OtherCIGNA
NY2799480OtherGHI
NY81786550OtherMULTIPLAN
NY2363748Medicaid
NY3C8909OtherHEALTHNET
NYP2882375OtherOXFORD
NY100228521702OtherAMERICAN CHOICE
NY398381OtherCONNETICARE
NY5452518OtherFIRST HEALTH
NY394671POtherHIP
NY81786550OtherMULTIPLAN
NY=========Other1199 NBF
NYH78734Medicare UPIN