Provider Demographics
NPI:1871503524
Name:ORTHOPEDIC REHAB ASSOCIATES PC
Entity Type:Organization
Organization Name:ORTHOPEDIC REHAB ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:LEMBO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:781-829-9966
Mailing Address - Street 1:300 OAK ST STE 450
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:MA
Mailing Address - Zip Code:02359-1960
Mailing Address - Country:US
Mailing Address - Phone:781-829-9966
Mailing Address - Fax:781-829-2164
Practice Address - Street 1:300 OAK ST STE 450
Practice Address - Street 2:
Practice Address - City:PEMBROKE
Practice Address - State:MA
Practice Address - Zip Code:02359-1960
Practice Address - Country:US
Practice Address - Phone:781-829-9966
Practice Address - Fax:781-829-2164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-08
Last Update Date:2010-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10914225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0030197OtherNEIGHBORHOOD HEALTH PLAN
MA9909211OtherCIGNA
MAAA30055OtherHARVARD PILGRIM HEALTHCAR
MAY61332OtherBLUE CROSS BLUE SHIELD
MA125316000OtherU.S DEPARTMENT OF LABOR
MA3279637OtherAETNA
MA698148OtherTUFTS
MA698148OtherTUFTS