Healthcare Provider Details

I. General information

NPI: 1992945950
Provider Name (Legal Business Name): CENTER FOR PHYSICAL MEDICINE&REHABILITATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2009
Last Update Date: 03/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42 RYKOWSKI LN SUITE1
MIDDLETOWN NY
10941-4018
US

IV. Provider business mailing address

42 RYKOWSKI LN SUITE 1
MIDDLETOWN NY
10941-4018
US

V. Phone/Fax

Practice location:
  • Phone: 845-695-2131
  • Fax: 845-695-2135
Mailing address:
  • Phone: 845-695-2131
  • Fax: 845-695-2135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number181211
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number0230141
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number022623
License Number StateNY

VIII. Authorized Official

Name: DR. NEAL R DUNKELMAN
Title or Position: OWNER
Credential: MD
Phone: 845-695-2131