Healthcare Provider Details

I. General information

NPI: 1487669172
Provider Name (Legal Business Name): ISLAND REHABILITATION AND NURSING CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 12/31/2024
Certification Date: 12/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5537 EXPRESSWAY DR N
HOLTSVILLE NY
11742-1316
US

IV. Provider business mailing address

5537 EXPRESSWAY DR N
HOLTSVILLE NY
11742-1316
US

V. Phone/Fax

Practice location:
  • Phone: 631-758-3336
  • Fax: 631-930-7413
Mailing address:
  • Phone: 631-758-3336
  • Fax: 631-930-7413

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number5151318N
License Number StateNY

VIII. Authorized Official

Name: MR. LOUIS VITERITTI
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 631-715-2511