Provider Demographics
NPI:1023310646
Name:THE REHABILITATION INSTITUTE, INC.
Entity type:Organization
Organization Name:THE REHABILITATION INSTITUTE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DARA
Authorized Official - Middle Name:L
Authorized Official - Last Name:GARY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-870-1600
Mailing Address - Street 1:191 SWEET HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:OLD BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11804-1342
Mailing Address - Country:US
Mailing Address - Phone:516-870-1600
Mailing Address - Fax:516-870-1671
Practice Address - Street 1:123 FROST ST STE B
Practice Address - Street 2:
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590-5027
Practice Address - Country:US
Practice Address - Phone:516-222-2092
Practice Address - Fax:516-222-2641
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-02
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02004671Medicaid
NY02702514Medicaid