Provider Demographics
NPI:1598939043
Name:PENINSULA-NRH REGIONAL REHABILITATION
Entity Type:Organization
Organization Name:PENINSULA-NRH REGIONAL REHABILITATION
Other - Org Name:NRH REGIONAL REHAB AT PENINSULA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSISTANT VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIO
Authorized Official - Middle Name:A
Authorized Official - Last Name:ZUNIGA
Authorized Official - Suffix:
Authorized Official - Credentials:AVP
Authorized Official - Phone:202-877-1177
Mailing Address - Street 1:100 E CARROLL ST
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-5422
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1324 BELMONT AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-4543
Practice Address - Country:US
Practice Address - Phone:410-543-7115
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-16
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD216690Medicare Oscar/Certification