Organization
CARDIAC REHAB CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAHID RASUL MD (PRESIDENT)
(917) 774-1787
Entity
Organization
Contact information
Practice address
128 W WASHINGTON ST, NANTICOKE, PA 18634-3113
(718) 534-7888
(718) 874-0088
Mailing address
PO BOX 3945, NEW HYDE PARK, NY 11040-8945
(917) 774-1787
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
251B00000X
Case Management Agency
—
—
261Q00000X
Clinic/Center
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
261QR0404X
Cardiac Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
01/03/2020
Last updated
01/03/2020
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