MEDICARE: REHABWORX PHYSICAL MEDICINE AND REHABILITATION, PLLC

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

General Provider Information

NPI Number	:	1457346348
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REHABWORX PHYSICAL MEDICINE AND REHABILITATION, PLLC

Provider Business Mailing Address
First Line	:	PO BOX 2003
Second Line	:
City	:	EAST SYRACUSE
State	:	NY
Zip	:	13057-4503
Country	:	US
Telephone Number	:	315-449-2208
Fax Number	:	315-362-5120

Provider Business Practice Location Address
First Line	:	5000 BRITTONFIELD PKWY
Second Line	:	SUITE A-122
City	:	EAST SYRACUSE
State	:	NY
Zip	:	13057-9226
Country	:	US
Telephone Number	:	311-523-4967
Fax Number	:	315-423-9680

Authorized Official
Title or Position	:	OWNER
Name	:	JEFFREY KAHN
Credential	:	MD
Telephone Number	:	315-234-9679

Provider Enumeration Date	:	09/16/2005
Last Update Date	:	09/22/2014

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