Provider Demographics
NPI:1770663601
Name:CHESAPEAKE REHABILITATION GROUP, INC.
Entity Type:Organization
Organization Name:CHESAPEAKE REHABILITATION GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DIMITRY
Authorized Official - Middle Name:A
Authorized Official - Last Name:KARGMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-576-7467
Mailing Address - Street 1:2171 E 70TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-6101
Mailing Address - Country:US
Mailing Address - Phone:917-576-7467
Mailing Address - Fax:212-212-5003
Practice Address - Street 1:49 SHIPPING PL # 61
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21222-4318
Practice Address - Country:US
Practice Address - Phone:410-285-7060
Practice Address - Fax:212-500-3338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy