Provider Demographics
NPI:1346087020
Name:REHAB 360 PLLC
Entity type:Organization
Organization Name:REHAB 360 PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:SIEGELE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-716-8506
Mailing Address - Street 1:225 CURRIER DR
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CT
Mailing Address - Zip Code:06477-2921
Mailing Address - Country:US
Mailing Address - Phone:610-716-8506
Mailing Address - Fax:
Practice Address - Street 1:2798 WHITNEY AVE
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06518-2554
Practice Address - Country:US
Practice Address - Phone:610-716-8506
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-10
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty