Provider Demographics
NPI:1508886896
Name:ADVANCED REHAB MEDICAL SERVICES, P.C.
Entity Type:Organization
Organization Name:ADVANCED REHAB MEDICAL SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FUTORAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-926-2223
Mailing Address - Street 1:PO BOX 195
Mailing Address - Street 2:
Mailing Address - City:ROSLYN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11577-0195
Mailing Address - Country:US
Mailing Address - Phone:718-265-9914
Mailing Address - Fax:516-625-5553
Practice Address - Street 1:1247 SUFFOLK AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:BRENTWOOD
Practice Address - State:NY
Practice Address - Zip Code:11717-4518
Practice Address - Country:US
Practice Address - Phone:718-265-9914
Practice Address - Fax:718-265-9219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY06783OtherGHI MEDICARE