Provider Demographics
NPI:1770971798
Name:HEALTH ADVANTAGE REHAB SERVICES INC
Entity type:Organization
Organization Name:HEALTH ADVANTAGE REHAB SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTITIONER / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GRIGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHTENDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-886-7569
Mailing Address - Street 1:3201 75TH ST
Mailing Address - Street 2:
Mailing Address - City:EAST ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11370-1807
Mailing Address - Country:US
Mailing Address - Phone:917-886-7569
Mailing Address - Fax:845-477-3565
Practice Address - Street 1:3000 EASTCHESTER RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-3202
Practice Address - Country:US
Practice Address - Phone:347-334-6860
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-29
Last Update Date:2015-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY21826112081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty