MEDICARE: REHABILITATION MEDICINE ASSOCIATES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician	100686	NY

General Provider Information

NPI Number	:	1083887632
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REHABILITATION MEDICINE ASSOCIATES

Provider Business Mailing Address
First Line	:	3435 DEKALB AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10467-2301
Country	:	US
Telephone Number	:	718-547-8899
Fax Number	:	718-547-9553

Provider Business Practice Location Address
First Line	:	3435 DEKALB AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10467-2301
Country	:	US
Telephone Number	:	718-547-8899
Fax Number	:	718-547-9553

Authorized Official
Title or Position	:	SENIOR PHYSICIAN
Name	:	DR. LENORE Z GLADSTONE
Credential	:	MD
Telephone Number	:	718-547-8899

Provider Enumeration Date	:	04/03/2008
Last Update Date	:	04/03/2008

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