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General NPI Number Information
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NPI Number | 1396713897
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Entity Type | Organization
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Legal Business Name | PHILADELPHIA REHAB MEDC
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Dates
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Enumeration Date | 03/09/2006
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Last Update Date | 03/05/2009
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Provider Practice Location Address
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Address Line | 7720 CASTOR AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19152-3602
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Country | US
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Telephone | 215-722-1525
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Fax | 215-722-7819
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Provider Business Mailing Address
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Address Line | 7720 CASTOR AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19152-3602
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Country | US
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Telephone | 215-722-1525
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Fax | 215-722-7819
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SRINIVAS ARAVA BHUMI
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Credential | M.D.
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Telephone | 215-722-5305
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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 | MD-019689-E
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License Number State | PA
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