Healthcare Provider Details

I. General information

NPI: 1588737571
Provider Name (Legal Business Name): MELWOOD REHABILITATION CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 05/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 PENNSYLVANIA AVE STE 6
UPPER MARLBORO MD
20772-3658
US

IV. Provider business mailing address

9500 PENNSYLVANIA AVE STE 6
UPPER MARLBORO MD
20772-3658
US

V. Phone/Fax

Practice location:
  • Phone: 301-599-8420
  • Fax: 301-599-8280
Mailing address:
  • Phone: 301-599-8420
  • Fax: 301-599-8280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number20955
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number15222
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number04073
License Number StateMD

VIII. Authorized Official

Name: DR. RAFIK A TARFA
Title or Position: OWNER
Credential: PT, MS, DPT
Phone: 301-599-8420