Provider Demographics
NPI:1740298447
Name:SUMMIT MEDICAL REHABILITATION PC
Entity type:Organization
Organization Name:SUMMIT MEDICAL REHABILITATION PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:M
Authorized Official - Last Name:DEMAYO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:814-288-4448
Mailing Address - Street 1:360 GOUCHER ST
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15905-3400
Mailing Address - Country:US
Mailing Address - Phone:814-288-4448
Mailing Address - Fax:814-288-4477
Practice Address - Street 1:360 GOUCHER ST
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15905-3400
Practice Address - Country:US
Practice Address - Phone:814-288-4448
Practice Address - Fax:814-288-4477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty