Provider Demographics
NPI:1134225295
Name:MULTICARE PHYSICIANS & REHABILITATION GROUP P.C.
Entity type:Organization
Organization Name:MULTICARE PHYSICIANS & REHABILITATION GROUP P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:F
Authorized Official - Last Name:CLUKEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:203-271-3296
Mailing Address - Street 1:28 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CHESHIRE
Mailing Address - State:CT
Mailing Address - Zip Code:06410-3108
Mailing Address - Country:US
Mailing Address - Phone:203-271-3296
Mailing Address - Fax:203-439-0261
Practice Address - Street 1:28 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CHESHIRE
Practice Address - State:CT
Practice Address - Zip Code:06410-3108
Practice Address - Country:US
Practice Address - Phone:203-271-3296
Practice Address - Fax:203-439-0261
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000277111N00000X
CT000247111N00000X
CT000478207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
C02430Medicare ID - Type Unspecified