Island Rehabilitative Services Corp

LBN: Island Rehabilitative Services Corp
Island Rehabilitative Services Corp is an health care organization with primary practice located at 25 Fanning St , Staten Island NY 10314-5307. The organization recently has only one registered license in Ambulatory Health Care Facilities / End-Stage Renal Disease (ESRD) Treatment, which is considered as the primary health care specialty. Island Rehabilitative Services Corp can be contacted via phone (347) 671-8399, or through Licciardi, Dominic via phone (718) 987-5942.

Contact Information

Primary practice address
25 Fanning St Staten Island NY 10314-5307
Phone: (347) 671-8399
Fax: (347) 671-8398
Website:
Map and Directions
Authorized official contact:
Name: Licciardi, Dominic
Phone: (718) 987-5942

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / End-Stage Renal Disease (ESRD) Treatment 261QE0700X 7004204R New York

Profile Details

NPI number 1669453502
LBN Legal business name Island Rehabilitative Services Corp
DBA Doing business as
Authorized official Licciardi, Dominic
Entity Organization
Organization subpart 1 Yes
Enumeration date Nov 8th, 2005
Last updated Sep 28th, 2011 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669453502 NPPES
New York MEDICAID 03004235
New York MEDICAID 00519755

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