Healthcare Provider Details

I. General information

NPI: 1952763237
Provider Name (Legal Business Name): PHYSICAL MEDICINE AND REHABILITATION SPECIALISTS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2016
Last Update Date: 06/03/2021
Certification Date: 06/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1623 MORGANTOWN RD
READING PA
19607-9455
US

IV. Provider business mailing address

PO BOX 664
OAKS PA
19456-0664
US

V. Phone/Fax

Practice location:
  • Phone: 267-888-8583
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberOS018013
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. DANIEL MCNEILL
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: D.O.
Phone: 570-856-8942