Provider Demographics
NPI:1053361261
Name:MID-ATLANTIC REHABILITATION ASSOCIATES P A
Entity type:Organization
Organization Name:MID-ATLANTIC REHABILITATION ASSOCIATES P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES./OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ARVIND
Authorized Official - Middle Name:B
Authorized Official - Last Name:BALIGA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-641-2581
Mailing Address - Street 1:PO BOX 8627
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08002-0627
Mailing Address - Country:US
Mailing Address - Phone:856-755-1616
Mailing Address - Fax:856-755-1616
Practice Address - Street 1:1750 ZION RD
Practice Address - Street 2:SUITE 103
Practice Address - City:NORTHFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08225-1844
Practice Address - Country:US
Practice Address - Phone:609-641-2581
Practice Address - Fax:609-641-6901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-10
Last Update Date:2017-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ743208OtherAMERIHEALTH ADMINISTRATOR
115192800OtherUS DEPT OF LABOR
NJ5503507Medicaid
NJ651882000OtherAMERIHEALTH HMO / PPO
628290OtherANTHEM BLUE SHIELD
200043485OtherRAILROAD MEDICARE
NJ115309OtherAETNA HMO / PPO
200043485OtherRAILROAD MEDICARE
NJ743208OtherAMERIHEALTH ADMINISTRATOR