DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: ISLAND REHABILITATIVE SERVICES CORP

MEDICARE: ISLAND REHABILITATIVE SERVICES CORP
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
1261QE0700XEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center7004204RNY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1669453502
Entity Type Code : Organization
Provider Name (Legal Business Name) : ISLAND REHABILITATIVE SERVICES CORP
Provider Business Mailing Address
First Line : 97 NEW DORP LN
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10306-2364
Country : US
Telephone Number : 718-448-5641
Fax Number : 718-876-5969
Provider Business Practice Location Address
First Line : 25 FANNING ST
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10314-5307
Country : US
Telephone Number : 347-671-8399
Fax Number : 347-671-8398
Authorized Official
Title or Position : ADMINISTRATOR
Name : MR. DOMINIC LICCIARDI
Credential :
Telephone Number : 718-987-5942
Provider Enumeration Date : 11/08/2005
Last Update Date : 09/28/2011

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
1659314193 — CLOVE LAKES REHABILITATION AND OUTPATIENT SERVICES
Practice Location Address:
25 FANNING ST
STATEN ISLAND, NY
10314-5307
Practice Phone: 718-289-7878
Practice Fax:
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 “ISLAND REHABILITATIVE SERVICES CORP ” 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.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.