Provider Demographics
NPI:1932353174
Name:ULTIMATE REHAB SPECIALISTS
Entity Type:Organization
Organization Name:ULTIMATE REHAB SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GERARD
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:DYBEL
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:978-985-2689
Mailing Address - Street 1:9 ERNIES DR
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:MA
Mailing Address - Zip Code:01460-1330
Mailing Address - Country:US
Mailing Address - Phone:978-985-2689
Mailing Address - Fax:
Practice Address - Street 1:9 ERNIES DR
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:MA
Practice Address - Zip Code:01460-1330
Practice Address - Country:US
Practice Address - Phone:978-985-2689
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-14
Last Update Date:2008-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8839261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA8839OtherDIVISION OF PROFESSIONAL LICENSURE