Healthcare Provider Details

I. General information

NPI: 1548257132
Provider Name (Legal Business Name): REGAL HEIGHTS REHAB & HEALTH CC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7005 35TH AVE
JACKSON HEIGHTS NY
11372-3970
US

IV. Provider business mailing address

7005 35TH AVE
JACKSON HEIGHTS NY
11372-3970
US

V. Phone/Fax

Practice location:
  • Phone: 718-662-5100
  • Fax: 718-565-9700
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number335820
License Number StateNY

VIII. Authorized Official

Name: KWANG LEE
Title or Position: ADMINISTRATOR
Credential:
Phone: 718-662-5100