Provider Demographics
NPI:1861859878
Name:L'REFUAH MEDICAL & REHABILITATION CENTER, INC.
Entity Type:Organization
Organization Name:L'REFUAH MEDICAL & REHABILITATION CENTER, INC.
Other - Org Name:EZRA MEDICAL WOMEN'S HEALTH CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:CREDENTIALING SECRETARY
Authorized Official - Prefix:MRS
Authorized Official - First Name:MIRYAM
Authorized Official - Middle Name:
Authorized Official - Last Name:NAKASH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-820-1872
Mailing Address - Street 1:1312 38TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-3612
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1260-78 60TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-4929
Practice Address - Country:US
Practice Address - Phone:718-686-7600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-21
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02157835Medicaid
NY331052OtherMEDICARE A
NYW86661OtherMEDICARE B