Provider Demographics
NPI:1912596776
Name:LIFELONG REHAB NEW ENGLAND INC.
Entity Type:Organization
Organization Name:LIFELONG REHAB NEW ENGLAND INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:CIOLINO
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:631-278-0665
Mailing Address - Street 1:290 TURNPIKE RD STE 5-326
Mailing Address - Street 2:
Mailing Address - City:WESTBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01581-2843
Mailing Address - Country:US
Mailing Address - Phone:631-278-0665
Mailing Address - Fax:631-532-4886
Practice Address - Street 1:290 TURNPIKE RD STE 5-326
Practice Address - Street 2:
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01581-2843
Practice Address - Country:US
Practice Address - Phone:631-278-0665
Practice Address - Fax:631-532-4886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-14
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty