Provider Demographics
NPI:1174709877
Name:MARYLAND REHAB ASSOCIATES LLC
Entity type:Organization
Organization Name:MARYLAND REHAB ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:F
Authorized Official - Last Name:TUMINELLI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:301-408-3776
Mailing Address - Street 1:1017 UNIVERSITY BLVD E STE 101
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20903-3704
Mailing Address - Country:US
Mailing Address - Phone:301-408-3776
Mailing Address - Fax:301-408-3799
Practice Address - Street 1:1017 UNIVERSITY BLVD E STE 101
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20903-3704
Practice Address - Country:US
Practice Address - Phone:301-408-3776
Practice Address - Fax:301-408-3799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-14
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDSO1644111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDU56128Medicare UPIN