Active NPI
Interdisciplinary Medical MGT
- Durable Medical Equipment & Medical Supplies
- Warren, OH
National Provider Identifier
1104904663
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- License
- 6881
- Legal business name
- INTERDISCIPLINARY MEDICAL MGT
- Practice address
- 2103 Niles Cortland Rd
Warren, OH 44484 - Phone
- (330) 544-3737
- Fax
- (330) 544-3904
- NPI assigned
- Nov 1, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Catherine A Stychno, OWNER
- Title
- President
- Phone
- (330) 544-3737
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 6881 | OH | |
| Durable Medical Equipment & Medical Supplies | 332B00000X | 6881 | OH | Primary |
Addresses
Primary practice location
2103 Niles Cortland Rd
Warren, OH 44484
Mailing address
2103 Niles Cortland Rd
Warren, OH 44484
Phone (330) 544-3737
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2365202 | Medicaid | OH |
Other names 1
- Great East Rehab Inc
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1757548800000",
"number": "1104904663",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2103 NILES CORTLAND RD",
"city": "WARREN",
"state": "OH",
"postal_code": "44484",
"telephone_number": "330-544-3737",
"fax_number": "330-544-3904"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2103 NILES CORTLAND RD",
"city": "WARREN",
"state": "OH",
"postal_code": "44484",
"telephone_number": "330-544-3737",
"fax_number": "330-544-3904"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "INTERDISCIPLINARY MEDICAL MGT",
"organizational_subpart": "NO",
"enumeration_date": "2006-11-01",
"last_updated": "2025-09-11",
"status": "A",
"authorized_official_last_name": "STYCHNO",
"authorized_official_first_name": "CATHERINE",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "330-544-3737",
"authorized_official_credential": "OWNER"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": "OH",
"license": "6881",
"primary": false
},
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "OH",
"license": "6881",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2365202",
"state": "OH"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Great East Rehab Inc",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Warren, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.