Healthcare Provider Details

I. General information

NPI: 1538184411
Provider Name (Legal Business Name): ALTERNATIVE REHAB INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1740 SOUTH ST SUITE 305
PHILA PA
19146-1514
US

IV. Provider business mailing address

1740 SOUTH ST SUITE 305
PHILA PA
19146-1514
US

V. Phone/Fax

Practice location:
  • Phone: 215-772-9800
  • Fax: 215-772-0329
Mailing address:
  • Phone: 215-772-9800
  • Fax: 215-772-0329

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VII. Legacy identifiers

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

VIII. Authorized Official

Name: MS. LISA A OLMO
Title or Position: VP, DIRECTOR OF OPERATIONS
Credential:
Phone: 215-772-9800