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General NPI Number Information
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NPI Number | 1235184201
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Entity Type | Organization
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Legal Business Name | SUNDANCE REHABILITATION AGENCY INC
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Dates
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Enumeration Date | 05/24/2006
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Last Update Date | 10/02/2013
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Provider Practice Location Address
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Address Line | 628 CONGDON STREET WEST
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City | MIDDLETOWN
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State | CT
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Zip | 06457-1967
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Country | US
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Telephone | 860-347-7144
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Fax | 860-347-3942
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Provider Business Mailing Address
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Address Line | 200 NORTHPOINTE CIR SUITE 302
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City | SEVEN FIELDS
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State | PA
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Zip | 16046-7861
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Country | US
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Telephone | 724-831-5044
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Fax | 610-612-5459
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Authorized Official
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Title or Position | PRESIDENT
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Name | DANIEL A HIRSCHFELD
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Credential |
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Telephone | 610-444-6350
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | N/A
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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