Pyramidal Rehab, PC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

4301082652 Issued in MI

Legal business name

PYRAMIDAL REHAB, PC

Practice address

1414 W Fair Ave
Suite 204
Marquette, MI 49855-2675

Phone

(906) 225-7740

NPI assigned

Feb 7, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mansour Miky, M.D.

Title

President

Phone

(906) 225-7740

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211241600000",
    "number": "1083686596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2837 US HIGHWAY 41 W",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498552252",
            "telephone_number": "906-225-3964",
            "fax_number": "906-226-3875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 W FAIR AVE",
            "address_2": "SUITE 204",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498552675",
            "telephone_number": "906-225-7740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PYRAMIDAL REHAB, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-07",
        "last_updated": "2008-05-20",
        "status": "A",
        "authorized_official_last_name": "MIKY",
        "authorized_official_first_name": "MANSOUR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "906-225-7740",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "4301082652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MI",
            "identifier": "2505210422",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104603246",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Nicole Prus, BCBA
• Katherine Pryor, ATC
• Psychiatric Associates of Marquette
• Psychological Services of Danville, PLLC
• Norman Alexander Purmal, FNP-C
• Islam K Quasem, M.D.
• Quickmd Medical Group PA
• Sara Lynn Rahoi
• Joshua Rajala, CRNA
• Kimberly A Randell-Kronschnabel, LMSW

• Physical Medicine & Rehabilitation Physician in Marquette, MI
• Providers in Marquette, MI by specialty
• Physical Medicine & Rehabilitation Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.