Provider Demographics
NPI:1629265699
Name:ALLIEDMEDICAL & REHABILITATION PC
Entity Type:Organization
Organization Name:ALLIEDMEDICAL & REHABILITATION PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHONFELD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:516-221-0225
Mailing Address - Street 1:1350 HICKSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-1219
Mailing Address - Country:US
Mailing Address - Phone:516-798-2345
Mailing Address - Fax:
Practice Address - Street 1:1350 HICKSVILLE RD
Practice Address - Street 2:
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-1219
Practice Address - Country:US
Practice Address - Phone:516-798-2345
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-03
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY202478208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
6002890002Medicare NSC
6002890001Medicare NSC