Provider Demographics
NPI:1801827076
Name:THE SILVERCREST CENTER FOR NURSING AND REHABILITATION
Entity Type:Organization
Organization Name:THE SILVERCREST CENTER FOR NURSING AND REHABILITATION
Other - Org Name:THE SILVERCREST CENTER FOR NURSING AND REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT/CHIEF FINANCIAL OFFI
Authorized Official - Prefix:MR
Authorized Official - First Name:MITCHELL
Authorized Official - Middle Name:J
Authorized Official - Last Name:DEFRIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-480-4067
Mailing Address - Street 1:144-45 87TH AVENUE
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11435-3109
Mailing Address - Country:US
Mailing Address - Phone:718-480-4000
Mailing Address - Fax:718-480-4028
Practice Address - Street 1:144-45 87TH AVENUE
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11435-3109
Practice Address - Country:US
Practice Address - Phone:718-480-4000
Practice Address - Fax:718-480-4028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2015-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7003372N261QR0400X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01215512Medicaid
NY01382Medicare PIN
NY01215512Medicaid