Provider Demographics
NPI:1366489593
Name:THE PALM TREE CENTER FRO NURSING AND REHABILITATION
Entity Type:Organization
Organization Name:THE PALM TREE CENTER FRO NURSING AND REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SHIMON
Authorized Official - Middle Name:
Authorized Official - Last Name:LEFKOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-633-3300
Mailing Address - Street 1:5606 15TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-4708
Mailing Address - Country:US
Mailing Address - Phone:718-851-1000
Mailing Address - Fax:718-732-3243
Practice Address - Street 1:5606 15TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-4708
Practice Address - Country:US
Practice Address - Phone:718-851-1000
Practice Address - Fax:718-732-3243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-31
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7001336N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00309595Medicaid
NY00309595Medicaid