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 11777-1928
(631) 474-6879
(631) 474-6448
Mailing address
200 BELLE TERRE RD, SUITE E140, PORT JEFFERSON, NY 11777-1928
(631) 474-6879
(631) 474-6448
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02289747
—
NY
Enumeration date
10/13/2006
Last updated
01/21/2010
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