MEDICARE: ULTIMATE HEALTH OUTCOMES INC

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
1	261QR0401X	Comprehensive Outpatient Rehabilitation Facility (CORF)	2912201R	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720066384
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ULTIMATE HEALTH OUTCOMES INC

Provider Business Mailing Address
First Line	:	2343 NEW HYDE PARK RD
Second Line	:
City	:	NEW HYDE PARK
State	:	NY
Zip	:	11040
Country	:	US
Telephone Number	:	516-437-7236
Fax Number	:	516-437-7237

Provider Business Practice Location Address
First Line	:	2343 NEW HYDE PARK RD
Second Line	:
City	:	NEW HYDE PARK
State	:	NY
Zip	:	11040
Country	:	US
Telephone Number	:	516-437-7236
Fax Number	:	516-437-7237

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. RICHARD MARKX
Credential	:
Telephone Number	:	516-437-7236

Provider Enumeration Date	:	01/04/2006
Last Update Date	:	08/22/2020

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