Healthcare Provider Details

I. General information

NPI: 1477638427
Provider Name (Legal Business Name): RIKI RIMBERG M.S.,P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 BAKER LN
SUFFERN NY
10901-2401
US

IV. Provider business mailing address

7 BAKER LN
SUFFERN NY
10901-2401
US

V. Phone/Fax

Practice location:
  • Phone: 845-354-3318
  • Fax: 845-354-7172
Mailing address:
  • Phone: 845-354-3318
  • Fax: 845-354-7172

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number8841-1
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: