Provider Demographics
NPI:1679509160
Name:REHABILITATION ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:REHABILITATION ASSOCIATES, P.A.
Other - Org Name:DELAWARE BACK PAIN & SPORTS REHABILITATION CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:WOLLASTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-529-8783
Mailing Address - Street 1:200 BIDDLE AVE, SPRINGSIDE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-3968
Mailing Address - Country:US
Mailing Address - Phone:302-529-8783
Mailing Address - Fax:302-529-1586
Practice Address - Street 1:2006 FOULK RD
Practice Address - Street 2:SUITE B
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-3644
Practice Address - Country:US
Practice Address - Phone:302-529-8783
Practice Address - Fax:302-529-1586
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE2272852000OtherAMERIHEATH-KEYSTONE
DE147504Medicaid
DE5707129OtherAETNA PPO
DE0632730OtherAETNA HMO
DE386606954OtherBLUE CROSS/BLUE SHIELD
DECC5686OtherRAILROAD MEDICARE
DE1595337OtherAMERIHEALTH
DE26774OtherCOVENTRY
DE386606954CHIOtherBC/BS-CHIRO
DECC5686OtherRAILROAD MEDICARE