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General NPI Number Information
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NPI Number | 1003041047
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Entity Type | Organization
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Legal Business Name | RELIANCE MEDICAL REHABILITATION, LLC
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Dates
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Enumeration Date | 05/20/2009
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Last Update Date | 05/20/2009
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Provider Practice Location Address
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Address Line | 3963-3965 JOG ROAD
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City | LAKE WORTH
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State | FL
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Zip | 33467-0000
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Country | US
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Telephone | 877-225-5876
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Fax |
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Provider Business Mailing Address
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Address Line | 125 NEWTOWN RD SUITE 200
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City | PLAINVIEW
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State | NY
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Zip | 11803-4314
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Country | US
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Telephone | 516-454-0700
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. TIMOTHY RAYMOND DAMADIAN
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Credential |
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Telephone | 516-454-0700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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