Healthcare Provider Details

I. General information

NPI: 1508033556
Provider Name (Legal Business Name): CONCORD NURSING & REHABILITATION CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2008
Last Update Date: 05/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 MADISON ST
BROOKLYN NY
11216-1509
US

IV. Provider business mailing address

300 MADISON ST
BROOKLYN NY
11216-1509
US

V. Phone/Fax

Practice location:
  • Phone: 718-636-7500
  • Fax: 718-636-7518
Mailing address:
  • Phone: 718-636-7500
  • Fax: 718-636-7518

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number261QA0600X
License Number StateNY

VIII. Authorized Official

Name: MRS. LILLIE M BRYANT-HOBBS
Title or Position: EXECUTIVE DIRECTOR
Credential: MHS
Phone: 718-636-7500