1255354288 NPI number — NEURO REHAB ASSOCIATES, INC

Table of content: (NPI 1255354288)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255354288 NPI number — NEURO REHAB ASSOCIATES, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEURO REHAB ASSOCIATES, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1255354288
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/12/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
70 BUTLER STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SALEM
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03079-3925
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-893-2900
Provider Business Mailing Address Fax Number:
603-898-1372

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
70 BUTLER STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SALEM
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03079-3925
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-893-2900
Provider Business Practice Location Address Fax Number:
603-898-1372
Provider Enumeration Date:
07/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CHAMPAGNE
Authorized Official First Name:
CHARLES
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
603-890-3002

Provider Taxonomy Codes

  • Taxonomy code: 283X00000X , with the licence number:  02362 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 903109 . This is a "TUFTS HEALTH PLAN OPD" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 303026 . This is a "NEW HAMPSHIRE BX" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 22626 . This is a "FALLON HEALTH PLAN OPD" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 902904 . This is a "HPHC OUTPATIENT" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 7201605 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2230302601 . This is a "MASS BC& BS" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 5004003 . This is a "UNITED HEALTHCARE OPD" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 80303026 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 900966 . This is a "TUFTS HEALTH PLAN INP" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 5000031 . This is a "UNITED HEALTHCARE INP" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 986847 . This is a "NETWORK HEALTH" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 42098 . This is a "FALLON HEALTH PLAN" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 902904 . This is a "HPHC INPATIENT" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com