MEDICARE: WOODMERE REHABILITATION AND HEALTH CARE CENTER, 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
1	376G00000X	Nursing Home Administrator		NY
2	314000000X	Skilled Nursing Facility	2950315N	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	:	1861495202
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WOODMERE REHABILITATION AND HEALTH CARE CENTER, INC.

Provider Business Mailing Address
First Line	:	121 FRANKLIN PLACE
Second Line	:
City	:	WOODMERE
State	:	NY
Zip	:	11598
Country	:	US
Telephone Number	:	516-374-9300
Fax Number	:	516-374-1786

Provider Business Practice Location Address
First Line	:	121 FRANKLIN PLACE
Second Line	:
City	:	WOODMERE
State	:	NY
Zip	:	11598
Country	:	US
Telephone Number	:	516-374-9300
Fax Number	:	516-374-1786

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	DEBORAH ANN FLACK
Credential	:	ADMINISTRATOR
Telephone Number	:	516-374-9300

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	04/06/2018

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