Organization
ADVANTAGE P M & R LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY E VINCENT (BILLING SPECIALIST)
(845) 344-4477
Entity
Organization
Contact information
Practice address
60 DUNNING RD, MIDDLETOWN, NY 10940
(845) 344-4477
(845) 344-6072
Mailing address
60 DUNNING RD, MIDDLETOWN, NY 10940-2215
(845) 344-4477
(845) 344-6072
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
2175981
NY
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
1928462
NY
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
2005021
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01575286
—
NY
05
—
02088562
—
NY
05
—
02688757
—
NY
Enumeration date
12/18/2006
Last updated
11/01/2011
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