Provider Demographics
NPI:1982205712
Name:REMOTE TECHNOLOGY REHAB ASSOCIATES LLC
Entity Type:Organization
Organization Name:REMOTE TECHNOLOGY REHAB ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MARKET DEVELOPMENT
Authorized Official - Prefix:
Authorized Official - First Name:KELSEY
Authorized Official - Middle Name:
Authorized Official - Last Name:SZUKHENT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-658-7522
Mailing Address - Street 1:2140 S DUPONT HWY
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:DE
Mailing Address - Zip Code:19934-1249
Mailing Address - Country:US
Mailing Address - Phone:203-658-7522
Mailing Address - Fax:
Practice Address - Street 1:2620 REGATTA DR STE 102
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-6892
Practice Address - Country:US
Practice Address - Phone:203-658-7522
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-06
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy