Provider Demographics
NPI:1265166623
Name:REBOUND PHYSICAL THERAPY AND PERFORMANCE
Entity type:Organization
Organization Name:REBOUND PHYSICAL THERAPY AND PERFORMANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:EVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LAFEMINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-717-8068
Mailing Address - Street 1:109 PONDVIEW DR
Mailing Address - Street 2:
Mailing Address - City:SOUTHINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06489-3948
Mailing Address - Country:US
Mailing Address - Phone:203-601-7446
Mailing Address - Fax:
Practice Address - Street 1:598 DEMING RD STE A
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:CT
Practice Address - Zip Code:06037-1659
Practice Address - Country:US
Practice Address - Phone:203-601-7446
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-12
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Single Specialty