Healthcare Provider Details

I. General information

NPI: 1447448527
Provider Name (Legal Business Name): CENTER FOR NURSING AND REHABILITATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2007
Last Update Date: 10/15/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 PROSPECT PL
BROOKLYN NY
11238-4205
US

IV. Provider business mailing address

520 PROSPECT PL
BROOKLYN NY
11238-4205
US

V. Phone/Fax

Practice location:
  • Phone: 171-863-6100
  • Fax: 171-885-7455
Mailing address:
  • Phone: 171-863-6100
  • Fax: 171-885-7455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number7001354N
License Number StateNY

VIII. Authorized Official

Name: MS. LIDIA F LEUDO
Title or Position: ASSISTANT DIRECTOR OF ADMISSION
Credential:
Phone: 171-863-6100