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General NPI Number Information
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NPI Number | 1073989703
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Entity Type | Organization
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Legal Business Name | REHABON INC
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Dates
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Enumeration Date | 08/17/2015
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Last Update Date | 08/17/2015
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Provider Practice Location Address
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Address Line | 4 BURNT BRIDGE RD
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City | SHARON
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State | MA
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Zip | 02067-2991
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Country | US
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Telephone | 312-730-4593
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Fax |
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Provider Business Mailing Address
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Address Line | 80 BRIDGE ST 207
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City | DEDHAM
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State | MA
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Zip | 02026-1765
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Country | US
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Telephone | 312-730-4593
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Fax |
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Authorized Official
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Title or Position | OWNER & CEO
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Name | IRFAN MEHMUD IBRAHIM
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Credential | PT
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Telephone | 312-730-4593
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 19060
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License Number State | MA
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