Provider Demographics
NPI:1689304834
Name:MOMENTUM REHAB CONSULTANTS, LLC
Entity Type:Organization
Organization Name:MOMENTUM REHAB CONSULTANTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER AND CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:VISHNEVETSKY
Authorized Official - Last Name:LIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-666-7990
Mailing Address - Street 1:80 WOOD LN
Mailing Address - Street 2:
Mailing Address - City:ACTON
Mailing Address - State:MA
Mailing Address - Zip Code:01720-4529
Mailing Address - Country:US
Mailing Address - Phone:718-666-7990
Mailing Address - Fax:
Practice Address - Street 1:145 WARD HILL AVE
Practice Address - Street 2:
Practice Address - City:BRADFORD
Practice Address - State:MA
Practice Address - Zip Code:01835-5896
Practice Address - Country:US
Practice Address - Phone:978-372-8000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-11
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
No283X00000XHospitalsRehabilitation HospitalGroup - Single Specialty