Healthcare Provider Details

I. General information

NPI: 1548323157
Provider Name (Legal Business Name): NEW VANDERBILT REHABILITATION AND CARE CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 12/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 VANDERBILT AVE
STATEN ISLAND NY
10304-2604
US

IV. Provider business mailing address

135 VANDERBILT AVE
STATEN ISLAND NY
10304-2604
US

V. Phone/Fax

Practice location:
  • Phone: 718-447-0701
  • Fax: 718-447-2952
Mailing address:
  • Phone: 718-447-0701
  • Fax: 718-447-2952

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number7004316N
License Number StateNY

VIII. Authorized Official

Name: MS. KAREN FIGUEROA
Title or Position: DIRECTOR OF ACCOUNTS RECEIVABLES
Credential:
Phone: 718-447-0701