Provider Demographics
NPI:1821710575
Name:NEW ENGLAND REHAB CLINIC, INC.
Entity Type:Organization
Organization Name:NEW ENGLAND REHAB CLINIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ISAAC
Authorized Official - Middle Name:
Authorized Official - Last Name:CHASSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-795-1555
Mailing Address - Street 1:192 LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-2501
Mailing Address - Country:US
Mailing Address - Phone:508-795-1555
Mailing Address - Fax:
Practice Address - Street 1:192 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-2501
Practice Address - Country:US
Practice Address - Phone:508-795-1555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-19
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty