Basic Information
Provider Information
NPI: 1922265149
EntityType: 2
ReplacementNPI:  
OrganizationName: KESSLER INSTITUTE FOR REHABILITATION INC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4714 GETTYSBURG RD
Address2: LEGAL DEPT
City: MECHANICSBURG
State: PA
PostalCode: 17055
CountryCode: US
TelephoneNumber: 7179754503
FaxNumber:  
Practice Location
Address1: 401 COVENTRY DR
Address2:  
City: PHILLIPSBURG
State: NJ
PostalCode: 088651969
CountryCode: US
TelephoneNumber: 7179754503
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/16/2008
LastUpdateDate: 05/16/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: TARVIN
AuthorizedOfficialFirstName: MICHAEL
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: VICE PRESIDENT
AuthorizedOfficialTelephone: 7179754503
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261QP2000X  Y Ambulatory Health Care FacilitiesClinic/CenterPhysical Therapy

No ID Information.


Home