Provider Demographics
NPI:1831591593
Name:APEX REHAB LLC
Entity type:Organization
Organization Name:APEX REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:FATIMA
Authorized Official - Middle Name:
Authorized Official - Last Name:GHADIALLY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:240-498-7490
Mailing Address - Street 1:14106 CHINKAPIN DR
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-7403
Mailing Address - Country:US
Mailing Address - Phone:240-498-7490
Mailing Address - Fax:
Practice Address - Street 1:806 W DIAMOND AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878-1415
Practice Address - Country:US
Practice Address - Phone:240-498-7490
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-24
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD381670Medicare PIN