Active NPI
Great East Rehabilitation, LLC
- Orthopedic Physical Therapist
- Warren, OH
National Provider Identifier
1154629004
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- PT006881
- Legal business name
- GREAT EAST REHABILITATION, LLC
- Practice address
- 953 Niles Cortland Rd SE
Warren, OH 44484-2538 - Phone
- (330) 652-2287
- Fax
- (330) 544-3904
- NPI assigned
- Mar 2, 2011
- Organization subpart
- Yes
- Parent organization
- 2103 NILES CORTLAND ROAD SE WARREN, OH 44484-3067
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Angela Mulichak
- Title
- Billing Coordinator
- Phone
- (330) 652-2287
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | PT006881 | OH | Primary |
Addresses
Primary practice location
953 Niles Cortland Rd SE
Warren, OH 44484-2538
Mailing address
2103 Niles Cortland Rd SE
Warren, OH 44484-3067
Phone (330) 652-2287
National Provider Directory
National Provider Directory- Part of
- Great East Rehabilitation LLC
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1299024000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1299196800000",
"number": "1154629004",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2103 NILES CORTLAND RD SE",
"city": "WARREN",
"state": "OH",
"postal_code": "444843067",
"telephone_number": "330-652-2287",
"fax_number": "330-544-3904"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "953 NILES CORTLAND RD SE",
"city": "WARREN",
"state": "OH",
"postal_code": "444842538",
"telephone_number": "330-652-2287",
"fax_number": "330-544-3904"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GREAT EAST REHABILITATION, LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "2103 NILES CORTLAND ROAD SE WARREN, OH 44484-3067",
"enumeration_date": "2011-03-02",
"last_updated": "2011-03-04",
"status": "A",
"authorized_official_last_name": "MULICHAK",
"authorized_official_first_name": "ANGELA",
"authorized_official_title_or_position": "BILLING COORDINATOR",
"authorized_official_telephone_number": "330-652-2287",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapist, Orthopedic",
"state": "OH",
"license": "PT006881",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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 Mar 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.