Provider Demographics
NPI:1881764694
Name:ADVANCED REHABILITATION SYSTEMS INC
Entity type:Organization
Organization Name:ADVANCED REHABILITATION SYSTEMS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:MARIO
Authorized Official - Last Name:POLICICCHIO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:412-321-9088
Mailing Address - Street 1:1607 LOWRIE STREET
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212
Mailing Address - Country:US
Mailing Address - Phone:412-321-9088
Mailing Address - Fax:412-321-9445
Practice Address - Street 1:1607 LOWRIE STREET
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212
Practice Address - Country:US
Practice Address - Phone:412-321-9088
Practice Address - Fax:412-321-9445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT003688L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01929209Medicaid
PA01929209Medicaid