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General NPI Number Information
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NPI Number | 1790452639
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Entity Type | Organization
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Legal Business Name | DITMAS PARK REHABILITATION & CARE CENTER LLC
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Dates
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Enumeration Date | 08/27/2021
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Last Update Date | 01/13/2025
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Provider Practice Location Address
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Address Line | 2107 DITMAS AVE
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City | BROOKLYN
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State | NY
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Zip | 11226-6903
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Country | US
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Telephone | 718-462-8100
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Fax |
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Provider Business Mailing Address
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Address Line | 2103 DITMAS AVE
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City | BROOKLYN
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State | NY
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Zip | 11226-6903
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Country | US
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Telephone | 718-462-8100
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | SHABSE OBERLANDER
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Credential |
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Telephone | 718-462-8100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3140N1450X
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Taxonomy Name | Pediatric Skilled Nursing Facility
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License Number |
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License Number State |
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