Provider Demographics
NPI:1992945950
Name:CENTER FOR PHYSICAL MEDICINE&REHABILITATION
Entity type:Organization
Organization Name:CENTER FOR PHYSICAL MEDICINE&REHABILITATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NEAL
Authorized Official - Middle Name:R
Authorized Official - Last Name:DUNKELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-695-2131
Mailing Address - Street 1:42 RYKOWSKI LN
Mailing Address - Street 2:SUITE 1
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10941-4018
Mailing Address - Country:US
Mailing Address - Phone:845-695-2131
Mailing Address - Fax:845-695-2135
Practice Address - Street 1:42 RYKOWSKI LN
Practice Address - Street 2:SUITE1
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10941-4018
Practice Address - Country:US
Practice Address - Phone:845-695-2131
Practice Address - Fax:845-695-2135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-03
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY181211174400000X
NY0230141225100000X
NY022623225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01735602Medicaid
NYF35308Medicare UPIN