Provider Demographics
NPI:1548582752
Name:REHABILITATION ASSOCIATES
Entity Type:Organization
Organization Name:REHABILITATION ASSOCIATES
Other - Org Name:DELAWARE BACK PAIN & SPORTS REHABILITATION CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BAKST
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:302-529-8783
Mailing Address - Street 1:2006 FOULK RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-3644
Mailing Address - Country:US
Mailing Address - Phone:302-529-8783
Mailing Address - Fax:302-529-1586
Practice Address - Street 1:2150 NEW CASTLE AVE
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:DE
Practice Address - Zip Code:19720-2009
Practice Address - Country:US
Practice Address - Phone:302-529-8783
Practice Address - Fax:302-529-1586
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-16
Last Update Date:2010-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE14704Medicaid
DE2272852000OtherAMERIHEALTH
DECC5686OtherRAILROAD MEDICARE
DE386606954OtherBC/BS
DE5707129OtherAETNA
DE5707129OtherAETNA
DE1679509160Medicare NSC