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General NPI Number Information
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NPI Number | 1548710882
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Entity Type | Organization
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Legal Business Name | CENTRAL PENNSYLVANIA REHABILITATION MEDICINE, INC
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Dates
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Enumeration Date | 10/11/2016
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Last Update Date | 05/15/2018
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Provider Practice Location Address
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Address Line | 460 RIVER AVE STE 1
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City | WILLIAMSPORT
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State | PA
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Zip | 17701
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Country | US
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Telephone | 570-601-4722
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Fax | 570-651-9485
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Provider Business Mailing Address
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Address Line | PO BOX 3367
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City | WILLIAMSPORT
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State | PA
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Zip | 17701-0367
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Country | US
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Telephone | 570-601-4722
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Fax | 570-651-9485
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Authorized Official
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Title or Position | OWNER
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Name | DR. EDWIN ROMAN
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Credential | MD
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Telephone | 570-560-2501
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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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