Healthcare Provider Details

I. General information

NPI: 1740375476
Provider Name (Legal Business Name): ST. MARY'S REHABILITATION CENTER FOR CHILDREN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 SPRING VALLEY RD
OSSINING NY
10562-2001
US

IV. Provider business mailing address

15 SPRING VALLEY RD
OSSINING NY
10562-2001
US

V. Phone/Fax

Practice location:
  • Phone: 914-333-7016
  • Fax: 914-333-7017
Mailing address:
  • Phone: 914-333-7016
  • Fax: 914-333-7017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number335667
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. BURTON GREBIN
Title or Position: CHIEF OPERATING OFFICER
Credential: M.D.
Phone: 718-281-8888