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NPI Code Detail

MEDICARE: CLOVE LAKES REHABILITATION AND OUTPATIENT SERVICES

MEDICARE: CLOVE LAKES REHABILITATION AND OUTPATIENT SERVICES
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
1235Z00000XSpeech-Language Pathologist
2225X00000XOccupational Therapist
3225100000XPhysical Therapist

Other Identifiers

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

General Provider Information

NPI Number : 1659314193
Entity Type Code : Organization
Provider Name (Legal Business Name) : CLOVE LAKES REHABILITATION AND OUTPATIENT SERVICES
Provider Business Mailing Address
First Line : 25 FANNING ST
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10314-5307
Country : US
Telephone Number : 718-289-7890
Fax Number : 718-761-8701
Provider Business Practice Location Address
First Line : 25 FANNING ST
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10314-5307
Country : US
Telephone Number : 718-289-7878
Fax Number :
Authorized Official
Title or Position : ADMINISTRATOR
Name : MARY BETH FRANCIS
Credential :
Telephone Number : 718-289-7034
Provider Enumeration Date : 06/13/2006
Last Update Date : 07/17/2007

Similar Medicare Providers

1417952417 — CLOVE LAKES HEALTH CARE AND REHABILITATION CENTER, INC.
Practice Location Address:
25 FANNING ST
STATEN ISLAND, NY
10314-5307
Practice Phone: 718-289-7900
Practice Fax: 718-289-7028
1669453502 — ISLAND REHABILITATIVE SERVICES CORP
Practice Location Address:
25 FANNING ST
STATEN ISLAND, NY
10314-5307
Practice Phone: 347-671-8399
Practice Fax: 347-671-8398
1750506853 — MR. JOHN THOMAS
Practice Location Address:
25 FANNING ST
STATEN ISLAND, NY
10314-5307
Practice Phone: 718-289-7004
Practice Fax:
1306086707 — MRS. SUMA MARIAM KURIAKOSE PT
Practice Location Address:
25 FANNING ST
STATEN ISLAND, NY
10314-5307
Practice Phone: 718-289-7019
Practice Fax:
1285038141 — WURAOLA ISMAILA
Practice Location Address:
25 FANNING ST
STATEN ISLAND, NY
10314-5307
Practice Phone: 718-289-7900
Practice Fax:
1134676588 — N/A
Practice Location Address:
25 FANNING ST
STATEN ISLAND, NY
10314-5307
Practice Phone: 718-698-2475
Practice Fax:

Directions to “CLOVE LAKES REHABILITATION AND OUTPATIENT SERVICES ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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