Provider Demographics
NPI:1922168590
Name:ABINGTON REHABILITATION MEDICINE
Entity Type:Organization
Organization Name:ABINGTON REHABILITATION MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:CHALISH
Authorized Official - Middle Name:
Authorized Official - Last Name:NIEVES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-830-9568
Mailing Address - Street 1:701 EASTON RD
Mailing Address - Street 2:
Mailing Address - City:WILLOW GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19090-2003
Mailing Address - Country:US
Mailing Address - Phone:215-830-9568
Mailing Address - Fax:215-830-9579
Practice Address - Street 1:701 EASTON RD
Practice Address - Street 2:
Practice Address - City:WILLOW GROVE
Practice Address - State:PA
Practice Address - Zip Code:19090-2003
Practice Address - Country:US
Practice Address - Phone:215-830-9568
Practice Address - Fax:215-830-9579
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA029257E208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA48462OtherKEYSTONE MERCY
PA590586OtherBLUE SHIELD
PAG416724OtherOXFORD HEALTH PLAN
PA139576OtherOAKTREE HEALTH PLAN
PA0011988930003OtherMEDICAID
PA20021149OtherAMERIHEALTH ADMINISTRATOR
PA68681OtherAETNA
PACK0451OtherRRB MEDICARE
PA0412650000OtherAMERIHEALTH
PA11547OtherHEALTH PARTNERS
PA0412650000OtherKEYSTONE HEALTH PLAN EAST
PA68681OtherAETNA
PAG416724OtherOXFORD HEALTH PLAN
PA11547OtherHEALTH PARTNERS
PACK0451OtherRRB MEDICARE