MEDICARE: EAST HAVEN NURSING AND 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	314000000X	Skilled Nursing Facility	7000360N	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	:	1801860291
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EAST HAVEN NURSING AND REHABILITATION CENTER

Provider Business Mailing Address
First Line	:	3530 WAYNE AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10467-1511
Country	:	US
Telephone Number	:	718-655-1700
Fax Number	:

Provider Business Practice Location Address
First Line	:	2323 EASTCHESTER RD
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10469-5910
Country	:	US
Telephone Number	:	718-655-2848
Fax Number	:	347-334-7563

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MS. GRACY VARGHESE
Credential	:
Telephone Number	:	718-655-2848

Provider Enumeration Date	:	02/14/2006
Last Update Date	:	04/15/2024

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