| Synergy Rehab Pc | |
| 
					3225 Shallowford Rd Ste 500 Marietta GA 30062-7024  | |
| (718) 534-0689 | |
| Not Available | 
| Full Name | Synergy Rehab Pc | 
|---|---|
| Speciality | Internal Medicine | 
| Location | 3225 Shallowford Rd Ste 500, Marietta, Georgia | 
| Authorized Official Name and Position | William Rivers (OWNER) | 
| Authorized Official Contact | 4787188747 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Synergy Rehab Pc 4770 White Plains Rd Bronx NY 10470-1136 Ph: () -  | Synergy Rehab Pc 3225 Shallowford Rd Ste 500 Marietta GA 30062-7024 Ph: (718) 534-0689  | 
| NPI Number | 1356100606 | 
|---|---|
| Provider Enumeration Date | 03/18/2024 | 
| Last Update Date | 02/20/2025 | 
| Medicare PECOS PAC ID | 1254773104 | 
|---|---|
| Medicare Enrollment ID | O20240523003443 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1356100606 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | (* (Not Available)) | Primary | 
| Provider Name | Tiwalade Olawuyi | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1114212115 PECOS PAC ID: 3375711039 Enrollment ID: I20110722000678  | 
| Provider Name | William Jacocks Rivers | 
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation | 
| Provider Identifiers | NPI Number: 1639468580 PECOS PAC ID: 9537306832 Enrollment ID: I20151012001557  | 
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