Provider Demographics
NPI:1548432438
Name:ULTIMATE HEALTH OUTCOMES, INC.
Entity type:Organization
Organization Name:ULTIMATE HEALTH OUTCOMES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:MARKX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-326-7859
Mailing Address - Street 1:2343 NEW HYDE PARK RD
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-1212
Mailing Address - Country:US
Mailing Address - Phone:516-437-7236
Mailing Address - Fax:516-437-7237
Practice Address - Street 1:125 KENNEDY DR
Practice Address - Street 2:SUITE 200
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788-4017
Practice Address - Country:US
Practice Address - Phone:631-951-0040
Practice Address - Fax:631-951-0044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-31
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
334534261QR0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02441532Medicaid
NY02441532Medicaid