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Contact Information

PREMIER EAST PHYSICAL MEDICINE AND REHABILITATION, PC
2920 ROUTE 112
MEDFORD, NY11763-1451
 Phone: 631-698-3500
 Fax: 631-698-3600
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Neuromuscular Medicine

2081N0008X 25 Physician/Physical Medicine and Rehabilitation
Indicates primary specialty

NPI Profile & details for PREMIER EAST PHYSICAL MEDICINE AND REHABILITATION, PC

NPI Number 1275829202
LBN Legal business name PREMIER EAST PHYSICAL MEDICINE AND REHABILITATION, PC
Authorized official RAJ TOLAT - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 06/28/2011
Last updated 04/07/2020 - About 6 years ago
Identifiers
NY License # 207587
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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