Provider Demographics
NPI:1013936392
Name:CAMBRIAN REHABILITATION ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:CAMBRIAN REHABILITATION ASSOCIATES, P.C.
Other - Org Name:PENNCARE PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:D
Authorized Official - Last Name:BURMEISTER
Authorized Official - Suffix:JR
Authorized Official - Credentials:BSPT
Authorized Official - Phone:814-672-5700
Mailing Address - Street 1:503 RAILROAD AVE
Mailing Address - Street 2:SUITE 3 PATTON PLAZA
Mailing Address - City:PATTON
Mailing Address - State:PA
Mailing Address - Zip Code:16668-1342
Mailing Address - Country:US
Mailing Address - Phone:814-674-2218
Mailing Address - Fax:814-674-3716
Practice Address - Street 1:503 RAILROAD AVE
Practice Address - Street 2:SUITE 3 PATTON PLAZA
Practice Address - City:PATTON
Practice Address - State:PA
Practice Address - Zip Code:16668-1342
Practice Address - Country:US
Practice Address - Phone:814-674-2216
Practice Address - Fax:814-674-3716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT006763-L225100000X
PAPT003879-L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA005842OtherHIGHMARK
PA01896995Medicaid
PA39-6660Medicare ID - Type UnspecifiedMEDICARE