Basic Information
| Provider Information | |||||||||
| NPI: | 1104041094 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | REHAB INSTITUTE OF SCOTTSDALE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10245 N 92ND ST STE 101 | ||||||||
| Address2: | |||||||||
| City: | SCOTTSDALE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852584563 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4807670555 | ||||||||
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| Practice Location | |||||||||
| Address1: | 10245 N 92ND ST | ||||||||
| Address2: | |||||||||
| City: | SCOTTSDALE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852584563 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4807670555 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/16/2007 | ||||||||
| LastUpdateDate: | 08/26/2008 | ||||||||
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| AuthorizedOfficialLastName: | SINGH | ||||||||
| AuthorizedOfficialFirstName: | RAJ | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 4807670555 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | 12583 | AZ | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
No ID Information.