Provider Demographics
NPI:1669743019
Name:SYNERGY HEALTHCARE CORPORATION
Entity type:Organization
Organization Name:SYNERGY HEALTHCARE CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER / PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:S
Authorized Official - Last Name:PEDERSEN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, PT
Authorized Official - Phone:508-991-2918
Mailing Address - Street 1:17 SARAHS WAY
Mailing Address - Street 2:
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-3161
Mailing Address - Country:US
Mailing Address - Phone:508-991-2918
Mailing Address - Fax:508-994-3068
Practice Address - Street 1:17 SARAHS WAY
Practice Address - Street 2:
Practice Address - City:FAIRHAVEN
Practice Address - State:MA
Practice Address - Zip Code:02719-3161
Practice Address - Country:US
Practice Address - Phone:508-991-2918
Practice Address - Fax:508-994-3068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-17
Last Update Date:2012-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty