Healthcare Provider Details

I. General information

NPI: 1396067419
Provider Name (Legal Business Name): REHABILITATION ASSOCIATES, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2010
Last Update Date: 03/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 BANNING ST STE 350
DOVER DE
19904-3485
US

IV. Provider business mailing address

2006 FOULK RD STE. B
WILMINGTON DE
19810-3644
US

V. Phone/Fax

Practice location:
  • Phone: 302-730-8848
  • Fax: 302-730-8846
Mailing address:
  • Phone: 302-529-8783
  • Fax: 302-529-1586

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. BARRY L BAKST
Title or Position: PRESIDENT
Credential: D.O.
Phone: 302-529-8783