Great East Rehabilitation LLC

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

PT004636 Issued in OH

Legal business name

GREAT EAST REHABILITATION LLC

Practice address

2103 Niles Cortland Rd SE
Warren, OH 44484-3067

Phone

(330) 652-2287

Fax

(330) 544-3904

NPI assigned

Sep 28, 2010

Organization subpart

No

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

Authorized official

Name

Mrs. Angela R Mulichak

Title

Contract Coordinator

Phone

(330) 652-2287

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1285632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285632000000",
    "number": "1902115769",
    "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": "2103 NILES CORTLAND RD SE",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444843067",
            "telephone_number": "330-652-2287",
            "fax_number": "330-544-3904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT EAST REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-28",
        "last_updated": "2010-09-28",
        "status": "A",
        "authorized_official_last_name": "MULICHAK",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CONTRACT 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": "PT004636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Graham, CDCA
• Ariel Renae Grant, PHARMD
• Rachel Lynn Grant, L.S.W
• Elizabeth Erin Gray, RN
• Lori Ann Gray
• Great East Rehabilitation, LLC
• Alicia Carol Greathouse
• Apostolis Green
• April Green
• Laila Green

• Orthopedic Physical Therapist in Warren, OH
• Providers in Warren, OH by specialty
• Orthopedic Physical Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2010; 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.