MEDICARE: REHABILITATION MEDICINE SPECIALIST, PC

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	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician	252645	NY

General Provider Information

NPI Number	:	1285934950
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REHABILITATION MEDICINE SPECIALIST, PC

Provider Business Mailing Address
First Line	:	2896 W 8TH ST
Second Line	:	#19N
City	:	BROOKLYN
State	:	NY
Zip	:	11224-3336
Country	:	US
Telephone Number	:	347-722-5509
Fax Number	:

Provider Business Practice Location Address
First Line	:	1549 RALPH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11236-3127
Country	:	US
Telephone Number	:	347-722-5509
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	ELIZABETH J CHANDLER
Credential	:	MD
Telephone Number	:	347-722-5509

Provider Enumeration Date	:	10/28/2010
Last Update Date	:	10/06/2011

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