MEDICARE: THE PALM TREE CENTER FRO NURSING AND REHABILITATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	7001336N	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366489593
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE PALM TREE CENTER FRO NURSING AND REHABILITATION

Provider Business Mailing Address
First Line	:	5606 15TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-4708
Country	:	US
Telephone Number	:	718-851-1000
Fax Number	:	718-732-3243

Provider Business Practice Location Address
First Line	:	5606 15TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-4708
Country	:	US
Telephone Number	:	718-851-1000
Fax Number	:	718-732-3243

Authorized Official
Title or Position	:	CEO
Name	:	MR. SHIMON LEFKOWITZ
Credential	:
Telephone Number	:	718-633-3300

Provider Enumeration Date	:	05/31/2006
Last Update Date	:	06/16/2008

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