Provider Demographics
NPI:1821171380
Name:SILVERCREST
Entity Type:Organization
Organization Name:SILVERCREST
Other - Org Name:THE SILVERCREST CENTER FOR NURSING AND REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR.V.P. AND ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:TRETOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-480-4000
Mailing Address - Street 1:14445 87TH AVE
Mailing Address - Street 2:
Mailing Address - City:BRIARWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11435-3109
Mailing Address - Country:US
Mailing Address - Phone:718-480-4000
Mailing Address - Fax:718-480-4050
Practice Address - Street 1:14445 87TH AVE
Practice Address - Street 2:
Practice Address - City:BRIARWOOD
Practice Address - State:NY
Practice Address - Zip Code:11435-3109
Practice Address - Country:US
Practice Address - Phone:718-480-4000
Practice Address - Fax:718-480-4050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7003372N332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1243280001Medicare NSC