Provider Demographics
NPI:1598787616
Name:SYNERGY REHAB, INC.
Entity Type:Organization
Organization Name:SYNERGY REHAB, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TAPAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:RAUT
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:248-298-0433
Mailing Address - Street 1:29877 TELEGRAPH RD STE 303
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-7660
Mailing Address - Country:US
Mailing Address - Phone:248-298-0433
Mailing Address - Fax:248-298-0434
Practice Address - Street 1:29877 TELEGRAPH RD STE 303
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-7660
Practice Address - Country:US
Practice Address - Phone:248-298-0433
Practice Address - Fax:248-298-0434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI650F359660OtherBLUE CROSS BLUE SHIELD
MI0P09390Medicare PIN