Healthcare Provider Details

I. General information

NPI: 1922435379
Provider Name (Legal Business Name): FORT TRYON CENTER FOR REHABILITATION AND NURSING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2013
Last Update Date: 05/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1916 PARK AVE STE 102
NEW YORK NY
10037-3738
US

IV. Provider business mailing address

801 W 190TH ST
NEW YORK NY
10040-3802
US

V. Phone/Fax

Practice location:
  • Phone: 212-543-6400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: A J WEISS
Title or Position: FINANCE
Credential:
Phone: 718-670-6300