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NPI Code Detail

MEDICARE: PHILADELPHIA REHABILITATION & SPORTS MEDICINE

MEDICARE: PHILADELPHIA REHABILITATION & SPORTS MEDICINE
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 PhysicianOS007450LPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1780871178
Entity Type Code : Organization
Provider Name (Legal Business Name) : PHILADELPHIA REHABILITATION & SPORTS MEDICINE
Provider Business Mailing Address
First Line : 1407 RHAWN ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19111-2803
Country : US
Telephone Number : 215-722-3948
Fax Number :
Provider Business Practice Location Address
First Line : 1407 RHAWN ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19111-2803
Country : US
Telephone Number : 267-738-6040
Fax Number :
Authorized Official
Title or Position : PHYSICIAN
Name : DR. MARGARET A GUEST
Credential : DO
Telephone Number : 267-738-6040
Provider Enumeration Date : 09/28/2007
Last Update Date : 11/13/2007

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Directions to “PHILADELPHIA REHABILITATION & SPORTS MEDICINE ” Practice Location

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