Provider Demographics
NPI:1386976876
Name:REHABILITATION ASSOCIATES, P.A.
Entity type:Organization
Organization Name:REHABILITATION ASSOCIATES, P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BAKST
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:302-529-8783
Mailing Address - Street 1:2006 FOULK RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-3644
Mailing Address - Country:US
Mailing Address - Phone:302-529-8783
Mailing Address - Fax:302-529-1586
Practice Address - Street 1:2006 FOULK RD
Practice Address - Street 2:SUITE B
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-3644
Practice Address - Country:US
Practice Address - Phone:302-529-8783
Practice Address - Fax:302-529-1586
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-08
Last Update Date:2010-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE147504Medicaid
DE2272852000OtherAMERIHEALTH
DE0632730OtherAETNA-HMO
DECC5686OtherRAILROAD MEDICARE
DE5707129OtherAETNA-PPO
DE147504Medicaid