MEDICARE: CONCORD NURSING & REHABILITATION CENTER

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
1	261QA0600X	Adult Day Care Clinic/Center	261QA0600X	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508033556
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONCORD NURSING & REHABILITATION CENTER

Provider Business Mailing Address
First Line	:	300 MADISON ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11216-1509
Country	:	US
Telephone Number	:	718-636-7500
Fax Number	:	718-636-7518

Provider Business Practice Location Address
First Line	:	300 MADISON ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11216-1509
Country	:	US
Telephone Number	:	718-636-7500
Fax Number	:	718-636-7518

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MRS. LILLIE M BRYANT-HOBBS
Credential	:	MHS
Telephone Number	:	718-636-7500

Provider Enumeration Date	:	05/09/2008
Last Update Date	:	05/09/2008

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