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NPI Code Detail

MEDICARE: IVYREHAB FOCUS, INC.

MEDICARE: IVYREHAB FOCUS, INC.
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
1208100000XPhysical Medicine & Rehabilitation Physician

General Provider Information

NPI Number : 1518105279
Entity Type Code : Organization
Provider Name (Legal Business Name) : IVYREHAB FOCUS, INC.
Provider Business Mailing Address
First Line : 1311 MAMARONECK AVE STE 140
Second Line :
City : WHITE PLAINS
State : NY
Zip : 10605-5224
Country : US
Telephone Number : 914-294-4050
Fax Number :
Provider Business Practice Location Address
First Line : 439 CHANNEL RD STE 102
Second Line :
City : LAKE WYLIE
State : SC
Zip : 29710-6101
Country : US
Telephone Number : 803-746-7800
Fax Number : 803-746-7807
Authorized Official
Title or Position : CEO
Name : MICHAEL RUCKER
Credential :
Telephone Number : 914-777-8700
Provider Enumeration Date : 02/03/2009
Last Update Date : 08/12/2022

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Directions to “IVYREHAB FOCUS, INC. ” Practice Location

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