Basic Information
| Provider Information | |||||||||
| NPI: | 1982630513 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | REHABILITATION & WELLNESS OT, PT PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 16 MAYBROOK RD | ||||||||
| Address2: | SUITE B | ||||||||
| City: | CAMPBELL HALL | ||||||||
| State: | NY | ||||||||
| PostalCode: | 109162743 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8456364344 | ||||||||
| FaxNumber: | 8456364355 | ||||||||
| Practice Location | |||||||||
| Address1: | 20 WALNUT ST | ||||||||
| Address2: | SUITE D | ||||||||
| City: | MONTGOMERY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 125492230 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8454575555 | ||||||||
| FaxNumber: | 8454575556 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/24/2006 | ||||||||
| LastUpdateDate: | 04/10/2015 | ||||||||
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| AuthorizedOfficialLastName: | ALBANESE | ||||||||
| AuthorizedOfficialFirstName: | CHRISTOPHER | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | PT | ||||||||
| AuthorizedOfficialTelephone: | 8454575555 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR0400X | Y | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation |
No ID Information.