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
StateLicense IDTaxonomies
N/A261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation