Healthcare Provider Details

I. General information

NPI: 1558808469
Provider Name (Legal Business Name): VETS CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2017
Last Update Date: 01/30/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2698 8TH AVE
NEW YORK NY
10030-1219
US

IV. Provider business mailing address

2698 8TH AVE
NEW YORK NY
10030-1219
US

V. Phone/Fax

Practice location:
  • Phone: 212-283-0653
  • Fax:
Mailing address:
  • Phone: 212-283-0653
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License Number
License Number StateNY

VIII. Authorized Official

Name: SAM LANE
Title or Position: DOCTOR
Credential:
Phone: 212-283-0653