1447414578 NPI number — REHABILITATION OPTIONS, PC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447414578 NPI number — REHABILITATION OPTIONS, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
REHABILITATION OPTIONS, PC
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:
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:
1447414578
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/17/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
142 HARVARD RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LITTLETON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01460-1002
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-479-2923
Provider Business Mailing Address Fax Number:
978-746-9502

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
564 DUTTON ST
Provider Second Line Business Practice Location Address:
2ND FLOOR
Provider Business Practice Location Address City Name:
LOWELL
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01854-4306
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-479-2923
Provider Business Practice Location Address Fax Number:
978-746-9502
Provider Enumeration Date:
07/17/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BROWNSON
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
978-479-2923

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  5494 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1893637 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".