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NPI Code Detail

MEDICARE: DITMAS PARK REHABILITATION & CARE CENTER LLC

MEDICARE: DITMAS PARK REHABILITATION & CARE CENTER LLC
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
1251J00000XNursing Care Agency
2314000000XSkilled Nursing Facility
33140N1450XPediatric Skilled Nursing Facility

General Provider Information

NPI Number : 1790452639
Entity Type Code : Organization
Provider Name (Legal Business Name) : DITMAS PARK REHABILITATION & CARE CENTER LLC
Provider Business Mailing Address
First Line : 2103 DITMAS AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11226-6903
Country : US
Telephone Number : 718-462-8100
Fax Number :
Provider Business Practice Location Address
First Line : 2107 DITMAS AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11226-6903
Country : US
Telephone Number : 718-462-8100
Fax Number :
Authorized Official
Title or Position : CEO
Name : SHABSE OBERLANDER
Credential :
Telephone Number : 718-462-8100
Provider Enumeration Date : 08/27/2021
Last Update Date : 01/13/2025

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Directions to “DITMAS PARK REHABILITATION & CARE CENTER LLC ” Practice Location

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