Provider Demographics
NPI:1922499656
Name:ROCKVILLE NEUROREHAB ASSOCIATES, LLC
Entity Type:Organization
Organization Name:ROCKVILLE NEUROREHAB ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGING MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:T
Authorized Official - Last Name:PITTMANN
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:240-380-2373
Mailing Address - Street 1:11423 COMMONWEALTH DR
Mailing Address - Street 2:UNIT T-1
Mailing Address - City:NORTH BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20852-2856
Mailing Address - Country:US
Mailing Address - Phone:240-380-2373
Mailing Address - Fax:888-965-0722
Practice Address - Street 1:11423 COMMONWEALTH DR
Practice Address - Street 2:UNIT T-1
Practice Address - City:NORTH BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20852-2856
Practice Address - Country:US
Practice Address - Phone:240-380-2373
Practice Address - Fax:888-965-0722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-17
Last Update Date:2015-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD07076261QH0700X
DCSLP000591261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech