Organization
PREMIER MED REHAB INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JAMUNA SIVAKANTHAN MD (PHYSICIAN OWNER)
(412) 918-2408
Entity
Organization
Contact information
Practice address
4810 LIBERTY AVENUE, SUITE 1000, PITTSBURGH, PA 15224-2108
(412) 918-2408
(412) 918-2411
Mailing address
4810 LIBERTY AVENUE, SUITE 1000, PITTSBURGH, PA 15224-2108
(412) 918-2408
(412) 918-2411
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
062181L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1702643
—
PA
Enumeration date
11/09/2007
Last updated
11/27/2007
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