Provider Demographics
NPI:1639245590
Name:BIALYSTOKER CENTER FOR NURSING & REHABILITATION
Entity Type:Organization
Organization Name:BIALYSTOKER CENTER FOR NURSING & REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:TAUB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-475-7755
Mailing Address - Street 1:228 E BROADWAY
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-5601
Mailing Address - Country:US
Mailing Address - Phone:212-475-7755
Mailing Address - Fax:212-777-8594
Practice Address - Street 1:228 E BROADWAY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-5601
Practice Address - Country:US
Practice Address - Phone:212-475-7755
Practice Address - Fax:212-777-8594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-24
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7002308NMedicaid
NY00311284Medicaid
NY00311284Medicaid