Healthcare Provider Details

I. General information

NPI: 1750350245
Provider Name (Legal Business Name): MADISON REHABILITATION CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2006
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date: 11/07/2007
Reactivation Date: 12/13/2007

III. Provider practice location address

1291 BOSTON POST RD
MADISON CT
06443-3476
US

IV. Provider business mailing address

4714 GETTYSBURG RD
MECHANICSBURG PA
17055-4325
US

V. Phone/Fax

Practice location:
  • Phone: 203-245-0001
  • Fax: 203-245-8930
Mailing address:
  • Phone: 717-972-1100
  • Fax: 717-975-9781

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number StateCT

VIII. Authorized Official

Name: JOHN D DUGGAN
Title or Position: CHIEF LEGAL OFFICER
Credential:
Phone: 717-972-1100