# GENESIS PHYSIATRY CONSULTANTS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386354017
- **Authorized official:** RUBEENA VINCENT (OWNER)
- **Authorized official phone:** (732) 986-3795

## Contact information

- **Practice address:** 3320 BENSON AVE, HALETHORPE, MD 21227-1035
- **Practice address phone:** (732) 986-3795
- **Mailing address:** 8508 QUEEN ELIZABETH BLVD, ANNANDALE, VA 22003-4308

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/05/2022
- **Last updated:** 07/17/2025