Provider Demographics
NPI:1902051519
Name:REHAB RESOURCES
Entity Type:Organization
Organization Name:REHAB RESOURCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:TENEYCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-345-4395
Mailing Address - Street 1:864 BAILEY RD
Mailing Address - Street 2:
Mailing Address - City:FABIUS
Mailing Address - State:NY
Mailing Address - Zip Code:13063-9781
Mailing Address - Country:US
Mailing Address - Phone:315-345-4395
Mailing Address - Fax:
Practice Address - Street 1:159 W 1ST ST
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:NY
Practice Address - Zip Code:13126-2045
Practice Address - Country:US
Practice Address - Phone:315-342-9575
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-24
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012769252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY012769OtherOCCUPATIONAL THERAPY LISCENSE