Provider Demographics
NPI:1164821120
Name:PARKER JEWISH INSTITUTE FOR HEALTH CARE AND REHABILITATION
Entity Type:Organization
Organization Name:PARKER JEWISH INSTITUTE FOR HEALTH CARE AND REHABILITATION
Other - Org Name:PARKER ON MADISON SOCIAL ADULT DAY CARE
Other - Org Type:Other Name
Authorized Official - Title/Position:SR. VICE PRESIDENT FOR FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:WERNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-289-2354
Mailing Address - Street 1:27111 76TH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-1436
Mailing Address - Country:US
Mailing Address - Phone:718-289-2354
Mailing Address - Fax:
Practice Address - Street 1:27111 76TH AVE
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-1436
Practice Address - Country:US
Practice Address - Phone:718-289-2354
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-15
Last Update Date:2017-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY261QA0600X
311500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========OtherSOCIAL DAY PROGRAM