Provider Demographics
NPI:1891057386
Name:OMNI REHAB
Entity Type:Organization
Organization Name:OMNI REHAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EVALUATOR/THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARI
Authorized Official - Middle Name:
Authorized Official - Last Name:SEEWALD
Authorized Official - Suffix:
Authorized Official - Credentials:MS ED
Authorized Official - Phone:516-569-7786
Mailing Address - Street 1:431 ARGYLE RD
Mailing Address - Street 2:
Mailing Address - City:CEDARHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11516-1234
Mailing Address - Country:US
Mailing Address - Phone:516-569-7786
Mailing Address - Fax:
Practice Address - Street 1:431 ARGYLE RD
Practice Address - Street 2:
Practice Address - City:CEDARHURST
Practice Address - State:NY
Practice Address - Zip Code:11516-1234
Practice Address - Country:US
Practice Address - Phone:516-569-7786
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-12
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY17440000Medicaid