Healthcare Provider Details

I. General information

NPI: 1164821120
Provider Name (Legal Business Name): PARKER JEWISH INSTITUTE FOR HEALTH CARE AND REHABILITATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2014
Last Update Date: 08/30/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27111 76TH AVE
NEW HYDE PARK NY
11040-1436
US

IV. Provider business mailing address

27111 76TH AVE
NEW HYDE PARK NY
11040-1436
US

V. Phone/Fax

Practice location:
  • Phone: 718-289-2354
  • Fax:
Mailing address:
  • Phone: 718-289-2354
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code311500000X
TaxonomyAlzheimer Center (Dementia Center)
License Number
License Number State

VIII. Authorized Official

Name: ROBERT M WERNER
Title or Position: SR. VICE PRESIDENT FOR FINANCE
Credential:
Phone: 718-289-2354