Provider Demographics
NPI:1578656385
Name:METROPOLITAN REHABILITATION MEDICINE PC
Entity Type:Organization
Organization Name:METROPOLITAN REHABILITATION MEDICINE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ABRAHAM
Authorized Official - Middle Name:T
Authorized Official - Last Name:RASUL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:202-997-6833
Mailing Address - Street 1:7877 HEATHERTON LN
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-3215
Mailing Address - Country:US
Mailing Address - Phone:202-526-0099
Mailing Address - Fax:202-526-3955
Practice Address - Street 1:1160 VARNUM ST NE
Practice Address - Street 2:SUITE 1008
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017-2107
Practice Address - Country:US
Practice Address - Phone:202-526-0099
Practice Address - Fax:202-526-3955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD30221261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCG01650 M01OtherMEDICARE
DCG01650 M01OtherMEDICARE