Provider Demographics
NPI:1912399924
Name:MEDICAL REHABILITATION CARE OF WESTERN NEW YORK, PLLC
Entity Type:Organization
Organization Name:MEDICAL REHABILITATION CARE OF WESTERN NEW YORK, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:SABIAH
Authorized Official - Middle Name:
Authorized Official - Last Name:BEG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-808-7420
Mailing Address - Street 1:4131 NW 13TH ST
Mailing Address - Street 2:SUITE 222
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32609-4151
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2950 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:KENMORE
Practice Address - State:NY
Practice Address - Zip Code:14217-1304
Practice Address - Country:US
Practice Address - Phone:407-808-7420
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-27
Last Update Date:2015-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY277799-1208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty