1598793473 NPI number — IN-SYNC REHABILITATION SERVICES, INC

Table of content: (NPI 1598793473)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598793473 NPI number — IN-SYNC REHABILITATION SERVICES, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
IN-SYNC REHABILITATION SERVICES, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1598793473
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/23/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3960 ROUTE 30
Provider Second Line Business Mailing Address:
SUITE 104
Provider Business Mailing Address City Name:
LATROBE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15650
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-532-3422
Provider Business Mailing Address Fax Number:
724-532-3424

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3960 ROUTE 30
Provider Second Line Business Practice Location Address:
SUITE 104
Provider Business Practice Location Address City Name:
LATROBE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16550
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-532-3422
Provider Business Practice Location Address Fax Number:
724-532-3424
Provider Enumeration Date:
06/29/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MCLEARY
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
W
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
724-532-3422

Provider Taxonomy Codes

  • Taxonomy code: 225X00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 9841133 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1472545 . This is a "HIGHMARK BC BS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1472545 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 116772 . This is a "HEALTH AMERICA/HEALTH ASSURANCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 116772 . This is a "HEALTH ASSURANCE/AMERICA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0619112 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".




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