Healthcare Provider Details

I. General information

NPI: 1033855440
Provider Name (Legal Business Name): PARAMOUNT REHABILITATION SERVICES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2022
Last Update Date: 06/13/2022
Certification Date: 05/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 PINE ST
CHESANING MI
48616-1252
US

IV. Provider business mailing address

202 PINE ST
CHESANING MI
48616-1252
US

V. Phone/Fax

Practice location:
  • Phone: 989-323-2090
  • Fax: 989-323-3991
Mailing address:
  • Phone: 989-323-2090
  • Fax: 989-323-3991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251H1200X
TaxonomyHand Physical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number
License Number State

VIII. Authorized Official

Name: SUNIL B MALEWAR
Title or Position: PARAMOUNT REHABILITATION SERVICES
Credential:
Phone: 989-891-9800