Provider Demographics
NPI:1497994800
Name:DITMAS PARK REHABILITATION & CARE CENTER LLC
Entity Type:Organization
Organization Name:DITMAS PARK REHABILITATION & CARE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SHABSE
Authorized Official - Middle Name:
Authorized Official - Last Name:OBERLANDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-462-8100
Mailing Address - Street 1:2107 DITMAS AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-6903
Mailing Address - Country:US
Mailing Address - Phone:718-462-8100
Mailing Address - Fax:718-941-6051
Practice Address - Street 1:2107 DITMAS AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-6903
Practice Address - Country:US
Practice Address - Phone:718-462-8100
Practice Address - Fax:718-941-6051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-09
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPENDING314000000X
3140N1450X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, Pediatric