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NPI Code Detail

MEDICARE: REHAB BY RVNA, LLC

MEDICARE: REHAB BY RVNA, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QR0400XRehabilitation Clinic/Center

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1D100325328OTHERCTMEDICARE PTAN

General Provider Information

NPI Number : 1285082099
Entity Type Code : Organization
Provider Name (Legal Business Name) : REHAB BY RVNA, LLC
Provider Business Mailing Address
First Line : 27 GOVERNOR ST
Second Line :
City : RIDGEFIELD
State : CT
Zip : 06877-4657
Country : US
Telephone Number : 203-438-5555
Fax Number : 203-431-5618
Provider Business Practice Location Address
First Line : 27 GOVERNOR ST
Second Line :
City : RIDGEFIELD
State : CT
Zip : 06877-4657
Country : US
Telephone Number : 203-438-5555
Fax Number : 203-431-5618
Authorized Official
Title or Position : FINANCE DIRECTOR
Name : MS. DEBRA J TREVELIN
Credential :
Telephone Number : 203-438-5555
Provider Enumeration Date : 06/02/2016
Last Update Date : 06/28/2024

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