Provider Demographics
NPI:1881724169
Name:NEW BEGINNING PEDIATRIC REHAB, INC.
Entity type:Organization
Organization Name:NEW BEGINNING PEDIATRIC REHAB, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARI
Authorized Official - Middle Name:L
Authorized Official - Last Name:MARCHESE-KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:410-796-8499
Mailing Address - Street 1:PO BOX 1343
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48347-1343
Mailing Address - Country:US
Mailing Address - Phone:410-796-8499
Mailing Address - Fax:877-384-9028
Practice Address - Street 1:9256 BENDIX RD
Practice Address - Street 2:STE 105/106
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-1840
Practice Address - Country:US
Practice Address - Phone:410-796-8499
Practice Address - Fax:877-384-9028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05556225XP0200X
MD06394235Z00000X
MD173892251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Single Specialty
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty