Provider Demographics
NPI: | 1952409120 |
---|---|
Name: | ULTIMATE REHABILITATION, INC. |
Entity Type: | Organization |
Organization Name: | ULTIMATE REHABILITATION, INC. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | ASHTIAQ |
Authorized Official - Middle Name: | HUSSAIN |
Authorized Official - Last Name: | KHOKHAR |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | PHYSICAL THERAPIST |
Authorized Official - Phone: | 301-525-4248 |
Mailing Address - Street 1: | 9500 ANNAPOLIS ROAD |
Mailing Address - Street 2: | SUITE A1 |
Mailing Address - City: | LANHAM |
Mailing Address - State: | MD |
Mailing Address - Zip Code: | 20706 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 301-575-4248 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 9500 ANNAPOLIS ROAD |
Practice Address - Street 2: | SUITE A1 |
Practice Address - City: | LANHAM |
Practice Address - State: | MD |
Practice Address - Zip Code: | 20706 |
Practice Address - Country: | US |
Practice Address - Phone: | 301-575-4248 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-09-20 |
Last Update Date: | 2020-08-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
N/A | 261QR0400X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QR0400X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation |