Provider Demographics
NPI:1225837875
Name:NORTHEASTERN REHABILITATION ASSOCIATES, PC
Entity type:Organization
Organization Name:NORTHEASTERN REHABILITATION ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:570-344-3788
Mailing Address - Street 1:20 MONTAGE MOUNTAIN ROAD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:MOOSIC
Mailing Address - State:PA
Mailing Address - Zip Code:18507
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:20 MONTAGE MOUNTAIN ROAD
Practice Address - Street 2:SUITE 1
Practice Address - City:MOOSIC
Practice Address - State:PA
Practice Address - Zip Code:18507
Practice Address - Country:US
Practice Address - Phone:570-344-3789
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTHEASTERN REHABILITATION ASSOCIATES, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-03-07
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical