ISLAND REHABILITATIVE SERVICES/B'KLYN – NPI #1790779114
Clinic/Center

ISLAND REHABILITATIVE SERVICES/B'KLYN is an AHC clinic located in BROOKLYN, NY. NPPES has assigned the NPI number 1790779114 to ISLAND REHABILITATIVE SERVICES/B'KLYN on August 31, 2005. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QE0700X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in End-Stage Renal Disease (ESRD) Treatment

The NPI profile was previously updated about 4 years ago on Jul 21, 2022. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for ISLAND REHABILITATIVE SERVICES/B'KLYN below.

NPI Profile for
ISLAND REHABILITATIVE SERVICES/B'KLYN

NPI Number
1790779114
Enumeration Date

(about 21 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
ISLAND REHABILITATIVE SERVICES/B'KLYN
Primary location
5918-5924 13TH AVE
ISLAND REHABILITATIVE SERVICES/B'KLYN
BROOKLYN, NY 11219
Phone: (718) 437-1594 Fax: (718) 437-5092
Mailing address
2031-10 FOREST AVE
ISLAND REHABILITATIVE SERVICES
STATEN ISLAND, NY 10303-1796
Phone: (718) 448-5641 Fax: (718) 448-6117
Organization Subpart
No
Authorized Official
DOMINIC LICCIARDI
ADMINISTRATOR
Phone: (718) 437-1594
Updated
Identifiers

Identifiers for ISLAND REHABILITATIVE SERVICES/B'KLYN

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDNY00519755
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QE0700X
- Clinic/Center / End-Stage Renal Disease (ESRD) Treatment (Primary)		 NY

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.