NPIMap

Organization Active NPI

Health Source Rehabilitation Inc

  • Physical Medicine & Rehabilitation Physician
  • Philadelphia, PA
National Provider Identifier
1881900868
Registry record updated Sep 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
HEALTH SOURCE REHABILITATION INC
Practice address
11880 Bustleton Ave
2ND Floor, Office B
Philadelphia, PA 19116-2538
Phone
(267) 239-1790
NPI assigned
Aug 27, 2010
Last updated
Sep 7, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2011

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

Authorized official

Name
Gennadiy Kalish
Title
President
Phone
(267) 239-1790

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

11880 Bustleton Ave
2ND Floor, Office B
Philadelphia, PA 19116-2538

Mailing address

11880 Bustleton Ave
2ND Floor, Office B
Philadelphia, PA 19116-2538

National Provider Directory

National Provider Directory

Locations

11880 Bustleton Ave
Ste B
Philadelphia, PA 19116
Phone (267) 239-1790

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1282867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315353600000",
    "number": "1881900868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11880 BUSTLETON AVE",
            "address_2": "2ND FLOOR, OFFICE B",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191162538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11880 BUSTLETON AVE",
            "address_2": "2ND FLOOR, OFFICE B",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191162538",
            "telephone_number": "267-239-1790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH SOURCE REHABILITATION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-27",
        "last_updated": "2011-09-07",
        "status": "A",
        "authorized_official_last_name": "KALISH",
        "authorized_official_first_name": "GENNADIY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "267-239-1790"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 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.

Verify at the official NPI Registry.