| 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 | 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 |
| Certification 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 | () | 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 |
| Provider Name | Justin Jacob Alexander |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1821300492 PECOS PAC ID: 2769600956 Enrollment ID: I20151103001725 |
| Provider Name | Chantia Reynolds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841156577 PECOS PAC ID: 5496231326 Enrollment ID: I20260204004237 |
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