Provider Demographics
NPI:1104060805
Name:PINNACLE REHABILITATION NETWORK LLC
Entity type:Organization
Organization Name:PINNACLE REHABILITATION NETWORK LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:COSTA NATARIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-388-7272
Mailing Address - Street 1:73 NEWTON RD
Mailing Address - Street 2:STE 101
Mailing Address - City:PLAISTOW
Mailing Address - State:NH
Mailing Address - Zip Code:03865-2424
Mailing Address - Country:US
Mailing Address - Phone:978-388-7272
Mailing Address - Fax:978-388-7373
Practice Address - Street 1:45 RESNIK RD STE 104A
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-4843
Practice Address - Country:US
Practice Address - Phone:508-747-6600
Practice Address - Fax:508-747-6606
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PINNACLE REHABILITATION NETWORK LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-04-24
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
MA532225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0010958Medicare PIN