MEDICARE: FEDCAP REHABILITATION SERVICES, INC

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	103TM1800X	Intellectual & Developmental Disabilities Psychologist

General Provider Information

NPI Number	:	1821563297
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FEDCAP REHABILITATION SERVICES, INC

Provider Business Mailing Address
First Line	:	633 3RD AVE FL 6
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10017-6943
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	214 OLD CHURCHMANS RD
Second Line	:
City	:	NEW CASTLE
State	:	DE
Zip	:	19720-1530
Country	:	US
Telephone Number	:	302-757-5587
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	CAROL KHOURY
Credential	:
Telephone Number	:	302-757-5587

Provider Enumeration Date	:	10/11/2018
Last Update Date	:	03/13/2025

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