Provider Demographics
NPI:1639234149
Name:MONTCLAIR CARE CENTER INC
Entity Type:Organization
Organization Name:MONTCLAIR CARE CENTER INC
Other - Org Name:EMERGE NURSING AND REHABILITATION AT GLEN COVE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ISSAC
Authorized Official - Middle Name:
Authorized Official - Last Name:LAUFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-671-0858
Mailing Address - Street 1:2 MEDICAL PLZ
Mailing Address - Street 2:
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542-2108
Mailing Address - Country:US
Mailing Address - Phone:516-671-0858
Mailing Address - Fax:516-671-0988
Practice Address - Street 1:2 MEDICAL PLZ
Practice Address - Street 2:
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542
Practice Address - Country:US
Practice Address - Phone:516-671-0858
Practice Address - Fax:516-671-0988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2018-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, Pediatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01800628Medicaid
NY01800628Medicaid