Provider Demographics
NPI:1508320474
Name:DR. MICHAEL J. REKAS, INC.
Entity Type:Organization
Organization Name:DR. MICHAEL J. REKAS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:REKAS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:401-821-5022
Mailing Address - Street 1:1567 CENTERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-4251
Mailing Address - Country:US
Mailing Address - Phone:401-821-5022
Mailing Address - Fax:401-821-4451
Practice Address - Street 1:1567 CENTERVILLE RD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-4251
Practice Address - Country:US
Practice Address - Phone:401-821-5022
Practice Address - Fax:401-821-4451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-24
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty