Provider Demographics
NPI:1871542704
Name:FRANKLIN MEDICAL REHAB INC
Entity type:Organization
Organization Name:FRANKLIN MEDICAL REHAB INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JACK
Authorized Official - Middle Name:J
Authorized Official - Last Name:CAMARDA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:516-775-4404
Mailing Address - Street 1:605 FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN SQUARE
Mailing Address - State:NY
Mailing Address - Zip Code:11010-1105
Mailing Address - Country:US
Mailing Address - Phone:516-775-4404
Mailing Address - Fax:516-775-4928
Practice Address - Street 1:605 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:FRANKLIN SQUARE
Practice Address - State:NY
Practice Address - Zip Code:11010-1105
Practice Address - Country:US
Practice Address - Phone:516-775-4404
Practice Address - Fax:516-775-4928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-08
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2950207R261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02722732Medicaid
WGW381Medicare PIN