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Organization
ADVANCED REHABILITATION MEDICINE PLLC
Active
Organization
ADVANCED REHABILITATION MEDICINE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLYN L FANELLI (PRACTICE MANAGER)
(631) 474-6049
Entity
Organization
Contact information
Practice address
200 BELLE TERRE RD, SUITE E140, PORT JEFFERSON, NY 11777
(631) 474-6879
(631) 474-6448
Mailing address
200 BELLE TERRE RD, SUITE E140, PORT JEFFERSON, NY 11777
(631) 474-6879
(631) 474-6448
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
11/01/2006
Last updated
08/22/2020
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