Provider Demographics
NPI:1831566801
Name:SYNERGY REHAB CENTER LLC
Entity type:Organization
Organization Name:SYNERGY REHAB CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SIZHU
Authorized Official - Middle Name:
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:240-447-6523
Mailing Address - Street 1:700 PROFESSIONAL DR
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20879-3418
Mailing Address - Country:US
Mailing Address - Phone:240-447-6523
Mailing Address - Fax:240-767-6058
Practice Address - Street 1:700 PROFESSIONAL DR
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20879-3418
Practice Address - Country:US
Practice Address - Phone:240-447-6523
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-26
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD25428261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD25428OtherMARYLAND BOARD OF PHYSICAL THERAPY