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General NPI Number Information
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NPI Number | 1326594227
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Entity Type | Organization
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Legal Business Name | APPLE REHAB
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Dates
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Enumeration Date | 08/30/2016
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Last Update Date | 08/30/2016
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Provider Practice Location Address
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Address Line | 3275 MAIN ST APT 104
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City | BRIDGEPORT
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State | CT
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Zip | 06606-4231
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Country | US
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Telephone | 718-578-1300
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Fax |
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Provider Business Mailing Address
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Address Line | 3275 MAIN ST APT 104
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City | BRIDGEPORT
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State | CT
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Zip | 06606-4231
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Country | US
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Telephone | 718-578-1300
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Fax |
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST
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Name | MRS. MARIE L FEUILLE
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Credential |
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Telephone | 718-578-1300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 004297
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License Number State | CT
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