Provider Demographics
NPI:1205372042
Name:SURGE REHABILITATION AND NURSING LLC
Entity Type:Organization
Organization Name:SURGE REHABILITATION AND NURSING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTS RECEIVABLE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LUCY
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSCHETTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-576-0600
Mailing Address - Street 1:49 OAKCREST AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLE ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:11953-1415
Mailing Address - Country:US
Mailing Address - Phone:718-939-7500
Mailing Address - Fax:718-559-4920
Practice Address - Street 1:49 OAKCREST AVE
Practice Address - Street 2:
Practice Address - City:MIDDLE ISLAND
Practice Address - State:NY
Practice Address - Zip Code:11953-1415
Practice Address - Country:US
Practice Address - Phone:718-939-7500
Practice Address - Fax:718-559-4920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-18
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5151315N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility