Healthcare Provider Details

I. General information

NPI: 1043684541
Provider Name (Legal Business Name): FEDCAP REHABILITATION SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2015
Last Update Date: 11/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 FERRY ST SUITE 308
CONCORD NH
03301-5022
US

IV. Provider business mailing address

633 3RD AVE FL 6
NEW YORK NY
10017-6733
US

V. Phone/Fax

Practice location:
  • Phone: 603-225-9540
  • Fax: 603-415-9543
Mailing address:
  • Phone: 212-727-7226
  • Fax: 212-727-4374

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: KAREN WEGMANN
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 212-727-4214