Organization
PERFORMANCE REHABILITATION OF WESTERN NEW ENGLAND LLC
Active
Other names
Performance Rehabilitation PC
Organization subpart
No
Provider details
NPI number
Authorized official
WADE A MEYER (VP CHIEF COMPLIANCE OFFICER)
(630) 296-2222
Entity
Organization
Contact information
Practice address
168 DENSLOW RD, EAST LONGMEADOW, MA 01028-3188
(413) 526-9969
(413) 526-9960
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440
(630) 296-2222
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
2251H1200X
Hand Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
—
225XH1200X
Hand Occupational Therapist
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03527
BMC ELM GROUP
MA
01
—
043527
CT CARE GROUP
MA
01
—
103355100
DOL GROUP
MA
01
—
28117
HNE GROUP
MA
01
—
35264
DENSLOW BMC GROUP
MA
01
—
35265
BIRNIE BMC GROUP
MA
01
—
64-04290
UNITED GROUP
MA
01
—
690675
TUFTS GROUP
MA
01
—
9715568
MASS HEALTH GROUP
MA
05
—
9715568
—
MA
01
—
972730
NETWORK HEALTH GROUP
MA
01
—
AA49027
HARVARD PILGRIM
MA
01
—
OG0011
BLUE CROSS
MA
01
—
PT0191
MEDICARE
MA
01
—
Y61264
BLUE CROSS PT
MA
Enumeration date
12/27/2006
Last updated
10/31/2024
Update your record
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