Provider Demographics
NPI:1972687135
Name:MASTER CARE REHABILITATION, PC
Entity Type:Organization
Organization Name:MASTER CARE REHABILITATION, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:RENATA
Authorized Official - Middle Name:EUGENIA
Authorized Official - Last Name:GARDEREWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-917-6557
Mailing Address - Street 1:PO BOX 14587
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19115-0587
Mailing Address - Country:US
Mailing Address - Phone:215-677-3700
Mailing Address - Fax:
Practice Address - Street 1:9808 BUSTLETON AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19115-2190
Practice Address - Country:US
Practice Address - Phone:215-677-3700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy