MEDICARE: FORWARD REHAB LLC

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	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1609564954
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FORWARD REHAB LLC

Provider Business Mailing Address
First Line	:	5111 CLARENDON RD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11203-5328
Country	:	US
Telephone Number	:	347-998-4151
Fax Number	:

Provider Business Practice Location Address
First Line	:	648 E 53RD ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11203-5916
Country	:	US
Telephone Number	:	347-998-4151
Fax Number	:

Authorized Official
Title or Position	:	OCCUPATIONAL THERAPIST
Name	:	CLINTON BELLE
Credential	:	OT
Telephone Number	:	347-998-4151

Provider Enumeration Date	:	04/25/2023
Last Update Date	:	04/25/2023

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Directions to “FORWARD REHAB LLC ” Practice Location

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