Provider Demographics
NPI:1548323157
Name:NEW VANDERBILT REHABILITATION AND CARE CENTER INC
Entity type:Organization
Organization Name:NEW VANDERBILT REHABILITATION AND CARE CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF ACCOUNTS RECEIVABLES
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:FIGUEROA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-447-0701
Mailing Address - Street 1:135 VANDERBILT AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10304-2604
Mailing Address - Country:US
Mailing Address - Phone:718-447-0701
Mailing Address - Fax:718-447-2952
Practice Address - Street 1:135 VANDERBILT AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10304-2604
Practice Address - Country:US
Practice Address - Phone:718-447-0701
Practice Address - Fax:718-447-2952
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7004316N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00308892Medicaid
NY007905OtherSKILLED NURSING HOME
NYUD756OtherSKILLED NURSING HOME
NYN31510OtherSKILLED NURSING HOME
NYIC3111OtherSKILLED NURSING HOME
NY300738OtherSKILLED NURSING HOME
NY176744OtherSKILLED NURSING HOME
NYIC3111OtherSKILLED NURSING HOME