MEDICAL DIAGNOSTICS AND REHABILITATION LLC (NPI# 1659454908) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659454908 |
| Entity Type | Organization |
| Organization Name | MEDICAL DIAGNOSTICS AND REHABILITATION LLC |
| Other Organization Name | THE MVA CENTER FOR REHABILITATION |
| Practice Address |
300 Stafford Street Suite 360 Springfield MA 01104 |
| Practice Telephone | 4137348440 |
| Practice Fax Number | 4137316703 |
| Mailing Telephone | 4137348440 |
| Mailing Fax Number | 4137316703 |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. MITCHELL I CLIONSKY (CEO MANAGER OF THE LLC) |
| Authorized Official Telephone | 4137348440 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 111N00000X | Chiropractor | Chiropractic Providers | ||
| X | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| X | 225100000X | Physical Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| X | 225200000X | Physical Therapy Assistant | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| X | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| Other Name | Type Code |
|---|---|
| The MVA Center for Rehabilitation | Doing Business As Name - Organization |
| Street Address |
300 STAFFORD STREET SUITE 360 |
| City | SPRINGFIELD |
| State | MA |
| Zip Code | 01104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215913439 | Candace G Mcdougall | Nurse Practitioner | 300 Stafford Street, Suites 154, 161, Springfield, MA 01104-2431 | 2005-12-20 |
| 1093963175 | Susan Y Lattanzi | Nurse Practitioner | 300 Stafford Street, Suites 101, 154 & 161, Springfield, MA 01104-2431 | 2008-09-03 |
| 1194940593 | Cameron Donaldson | Internal Medicine | 300 Stafford Street, #154/101, Springfield, MA 01104 | 2007-04-13 |
| 1598830606 | Chanel G Bouchereau | Surgery | 300 Stafford Street, Suite 113, Springfield, MA 01104-3581 | 2006-11-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346727567 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 2155 Main Street, Suite 131/133, Springfield, MA 01104 | 2018-07-20 |
| 1508385618 | Demetrios Sotiropoulos | Physician Assistant | 175 Carew St Ste 250, Springfield, MA 01104 | 2017-09-11 |
| 1114382942 | Rosana Rivera-delgado | Psychologist | 4017 Liberty St, Springfield, MA 01104 | 2015-12-21 |
| 1417363516 | Springfield Family Pharmacy, Inc | Pharmacy | 175 Carew St, Suite 100, Springfield, MA 01104 | 2014-07-09 |
| 1437588837 | Ariam Ivette Pena | Counselor | 85 St. George Road, Springfield, MA 01104 | 2013-11-06 |
| 1891124293 | Ana E. Centeno | Counselor | 85 St. George Road., Springfield, MA 01104 | 2013-11-06 |
| 1275962003 | Swany Matos | Counselor | 2155 Main St., Springfield, MA 01104 | 2013-11-02 |
| 1184053910 | Claudia Eileen Quesada | Counselor | 2155 Main Street and St. George Road, The Gandara Center, Springfield, MA 01104 | 2013-11-02 |
| 1194023044 | Hungry Hill Family Practice | Clinic/Center | 776 Liberty Street, Hungry Hill Family Practice, Springfield, MA 01104 | 2011-03-02 |
| 1710115308 | Michael Allen Roche | Counselor | 332 Bernie Ave, Center for Human Development, Springfield, MA 01104 | 2009-06-23 |
| Find all providers in zip 01104 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376140616 | Springfield Chiropractic LLC | Chiropractor | 505 N Laurel St, Springfield, GA 31329-6815 | 2020-10-08 |
| 1578179412 | James Crawford | Chiropractor | 2144 E Republic Rd Ste A104, Springfield, MO 65804-4645 | 2020-09-16 |
| 1982218103 | Western Mass Chiropractic PC | Chiropractor | 275 Bicentennial Hwy Ste 211, Springfield, MA 01118-1965 | 2020-09-04 |
| 1730725425 | Chiro One Wellness Center of Springfield, LLC | Chiropractor | 3409 Freedom Dr Ste 150a, Springfield, IL 62704-6517 | 2019-11-18 |
| 1508408493 | Amrit Justin Jhauj | Chiropractor | 355 Us-22 East, Springfield, NJ 07081 | 2019-10-11 |
| 1992355473 | Candace Bahk Kim | Chiropractor | 6225 Brandon Ave Ste 175, Springfield, VA 22150-2519 | 2019-09-16 |
| 1558826545 | Adrian Bryon Hunter | Chiropractor | 6130 Brandon Ave, Springfield, VA 22150-2610 | 2019-02-05 |
| 1720554959 | Revive Health and Injury Center, LLC | Chiropractor | 333 N Limestone St Ste 104, Springfield, OH 45503-4250 | 2018-10-15 |
| 1831693621 | Michael Benjamin Chiapetto | Chiropractor | 1340 S State St, Springfield, IL 62704-3625 | 2018-03-19 |
| 1134637382 | Gnr Chiropractic LLC | Chiropractor | 2700 W Lawrence Ave Ste J3, Springfield, IL 62704-7201 | 2018-01-22 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 01104 |
Please comment or provide details below to improve the information on MEDICAL DIAGNOSTICS AND REHABILITATION LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.