Provider Demographics
NPI:1952515017
Name:SUMMIT REHABILITATION MEDICINE, INC.
Entity Type:Organization
Organization Name:SUMMIT REHABILITATION MEDICINE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DELAHANTY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:330-784-9306
Mailing Address - Street 1:405 TALLMADGE RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44221-3342
Mailing Address - Country:US
Mailing Address - Phone:330-784-9306
Mailing Address - Fax:
Practice Address - Street 1:405 TALLMADGE RD
Practice Address - Street 2:SUITE 120
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44221-3342
Practice Address - Country:US
Practice Address - Phone:330-784-9306
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2010-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9930272Medicare ID - Type Unspecified