Organization Active NPI

Total Medical and Rehabilitation PC

  • Physical Medicine & Rehabilitation Physician
  • Riverhead, NY
National Provider Identifier
1164915195
Registry record updated Jun 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
TOTAL MEDICAL AND REHABILITATION PC
Practice address
550 E Main St Ste 100
Riverhead, NY 11901-2672
Phone
(631) 317-1010
NPI assigned
Jun 13, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2018

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

Authorized official

Name
Dr. Edward Tanza
Title
Ceo
Phone
(904) 654-2410

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

550 E Main St Ste 100
Riverhead, NY 11901-2672

Mailing address

665 Treehouse Cir
Saint Augustine, FL 32095-6837
Phone (904) 654-2410

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1528848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528848000000",
    "number": "1164915195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "665 TREEHOUSE CIR",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320956837",
            "telephone_number": "904-654-2410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 E MAIN ST STE 100",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119012672",
            "telephone_number": "631-317-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL MEDICAL AND REHABILITATION PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-13",
        "last_updated": "2018-06-13",
        "status": "A",
        "authorized_official_last_name": "TANZA",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "904-654-2410",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverhead, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2018; 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.