Pioneer Rehab LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

007901 Issued in CT

Legal business name

PIONEER REHAB LLC

Practice address

1650 Dixwell Ave
Hamden, CT 06514-3615

Phone

(708) 271-7371

NPI assigned

Sep 15, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Saifulla Mirza, RPTNPI 1801114475

Title

President

Phone

(708) 271-7371

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Saifulla Baig Mirza, RPT

  • Physical Therapist
  • North Haven, CT
  • NPI 1801114475
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1473897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473897600000",
    "number": "1164970489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 DIXWELL AVE",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065143615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 DIXWELL AVE",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065143615",
            "telephone_number": "708-271-7371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIONEER REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-15",
        "last_updated": "2016-09-15",
        "status": "A",
        "authorized_official_last_name": "MIRZA",
        "authorized_official_first_name": "SAIFULLA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-271-7371",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "RPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "007901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Hamden, CT
• Providers in Hamden, CT by specialty
• Physical Therapist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.