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NPI Code Detail

MEDICARE: CONCOURSE REHAB & NURSING CTR INC.

MEDICARE: CONCOURSE REHAB & NURSING CTR INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility7000375NNY

General Provider Information

NPI Number : 1467457002
Entity Type Code : Organization
Provider Name (Legal Business Name) : CONCOURSE REHAB & NURSING CTR INC.
Provider Business Mailing Address
First Line : 1072 GRAND CONCOURSE
Second Line :
City : BRONX
State : NY
Zip : 10456-3901
Country : US
Telephone Number : 718-681-4000
Fax Number : 718-764-8860
Provider Business Practice Location Address
First Line : 1072 GRAND CONCOURSE
Second Line :
City : BRONX
State : NY
Zip : 10456-3901
Country : US
Telephone Number : 718-681-4000
Fax Number : 718-764-8860
Authorized Official
Title or Position : CONTROLLER
Name : MR. SOLOMON NEIMAN
Credential : CPA
Telephone Number : 718-681-4000
Provider Enumeration Date : 06/20/2005
Last Update Date : 10/08/2015

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