Healthcare Provider Details

I. General information

NPI: 1821163064
Provider Name (Legal Business Name): DEWITT REHABILITATION AND NURSING CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2006
Last Update Date: 04/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 E 79TH ST
NEW YORK NY
10021-0819
US

IV. Provider business mailing address

211 E 79TH ST
NEW YORK NY
10021-0819
US

V. Phone/Fax

Practice location:
  • Phone: 212-671-6000
  • Fax: 212-879-4594
Mailing address:
  • Phone: 212-671-6000
  • Fax: 212-879-4594

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number
License Number State

VIII. Authorized Official

Name: MR. EDWARD AHRENS
Title or Position: DIRECTOR OF PHARMACY
Credential: PHARMACIST
Phone: 212-671-6000