Provider Demographics
NPI:1598344962
Name:PHYSIATRY CONSULTANTS LLC
Entity Type:Organization
Organization Name:PHYSIATRY CONSULTANTS LLC
Other - Org Name:NONE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEMMRY
Authorized Official - Middle Name:
Authorized Official - Last Name:PANTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-647-0345
Mailing Address - Street 1:43 FLICKER CT
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-5571
Mailing Address - Country:US
Mailing Address - Phone:917-379-8964
Mailing Address - Fax:
Practice Address - Street 1:43 FLICKER CT
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-5571
Practice Address - Country:US
Practice Address - Phone:917-379-8964
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-05
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
No2081N0008XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationNeuromuscular MedicineGroup - Single Specialty
No2081P0301XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationBrain Injury MedicineGroup - Single Specialty
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty
No2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports MedicineGroup - Single Specialty