Healthcare Provider Details

I. General information

NPI: 1659347300
Provider Name (Legal Business Name): REHABILITATION ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2006
Last Update Date: 06/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1931 BLACK ROCK TPKE
FAIRFIELD CT
06825-3506
US

IV. Provider business mailing address

1931 BLACK ROCK TPKE
FAIRFIELD CT
06825-3506
US

V. Phone/Fax

Practice location:
  • Phone: 203-384-8681
  • Fax: 203-384-0722
Mailing address:
  • Phone: 203-384-8681
  • Fax: 203-384-0722

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR0401X
TaxonomyComprehensive Outpatient Rehabilitation Facility (CORF)
License Number
License Number StateCT

VIII. Authorized Official

Name: MRS. CAROL LANDSMAN
Title or Position: DIRECTOR
Credential: MACCC-SLP
Phone: 203-384-8681