Provider Demographics
NPI:1689641805
Name:RHEUMATOLOGY & HAND REHABILITAION CENTER
Entity Type:Organization
Organization Name:RHEUMATOLOGY & HAND REHABILITAION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARY-ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:FLYNN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-288-0090
Mailing Address - Street 1:3018 DIXWELL AVE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06518-3508
Mailing Address - Country:US
Mailing Address - Phone:203-288-0090
Mailing Address - Fax:203-407-0558
Practice Address - Street 1:3018 DIXWELL AVE
Practice Address - Street 2:3RD FLOOR
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06518-3508
Practice Address - Country:US
Practice Address - Phone:203-288-0090
Practice Address - Fax:203-407-0558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-07
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT100001OtherORTHONET
0783560001OtherNHIC MEDICARE DME MACA
CT50RHEUMHACT01OtherANTHEM ID NUMBER
CT2V8314OtherHEALTHNET
CTA664439OtherOXFORD ID NUMBER
CT076524Medicare ID - Type Unspecified
CT076524Medicare Oscar/Certification
CT100001OtherORTHONET