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General NPI Number Information
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NPI Number | 1053357533
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Entity Type | Organization
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Legal Business Name | MOUNT SINAI REHABILITATION HOSPITAL, INC.
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Dates
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Enumeration Date | 06/21/2006
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Last Update Date | 06/11/2025
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Provider Practice Location Address
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Address Line | 490 BLUE HILLS AVE
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City | HARTFORD
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State | CT
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Zip | 06112-1513
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Country | US
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Telephone | 860-714-4953
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Fax |
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Provider Business Mailing Address
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Address Line | 114 WOODLAND ST
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City | HARTFORD
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State | CT
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Zip | 06105-1208
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Country | US
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Telephone | 860-714-4000
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | VALERIE POWELL-STAFFORD
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Credential |
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Telephone | 860-714-5387
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283X00000X
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Taxonomy Name | Rehabilitation Hospital
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License Number | 17CD
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License Number State | CT
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