Provider Demographics
NPI:1891952362
Name:ELITE MEDICAL & REHABILITATION, PC
Entity Type:Organization
Organization Name:ELITE MEDICAL & REHABILITATION, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PM&R SPECIALIST
Authorized Official - Prefix:MR
Authorized Official - First Name:SAWEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HARHASH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-819-2920
Mailing Address - Street 1:4828 202ND ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11364-1035
Mailing Address - Country:US
Mailing Address - Phone:718-819-2920
Mailing Address - Fax:718-819-2923
Practice Address - Street 1:4828 202ND ST
Practice Address - Street 2:
Practice Address - City:OAKLAND GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11364-1035
Practice Address - Country:US
Practice Address - Phone:718-819-2920
Practice Address - Fax:718-819-2923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-21
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY237111208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty