Provider Demographics
NPI:1386702926
Name:ELECTRODIAGNOSIS & REHABILITATION MEDICINE INC PS
Entity type:Organization
Organization Name:ELECTRODIAGNOSIS & REHABILITATION MEDICINE INC PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SANTOSH
Authorized Official - Middle Name:
Authorized Official - Last Name:KUMAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:425-258-6446
Mailing Address - Street 1:3223 COLBY AVE
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-4306
Mailing Address - Country:US
Mailing Address - Phone:425-258-6446
Mailing Address - Fax:425-258-9696
Practice Address - Street 1:3223 COLBY AVE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-4306
Practice Address - Country:US
Practice Address - Phone:425-258-6446
Practice Address - Fax:425-258-9696
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2015-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty