Provider Demographics
NPI:1871031666
Name:PA REHAB ASSOCIATES
Entity Type:Organization
Organization Name:PA REHAB ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NIRALI
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:908-370-9104
Mailing Address - Street 1:375 E ELM ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:CONSHOHOCKEN
Mailing Address - State:PA
Mailing Address - Zip Code:19428-1973
Mailing Address - Country:US
Mailing Address - Phone:908-370-9104
Mailing Address - Fax:484-212-7641
Practice Address - Street 1:1501 LANSDOWNE AVE
Practice Address - Street 2:SUITE 303
Practice Address - City:DARBY
Practice Address - State:PA
Practice Address - Zip Code:19023-1333
Practice Address - Country:US
Practice Address - Phone:484-494-8646
Practice Address - Fax:484-494-0226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-01
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD042916L332900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site