# DE WITT REHAB AND NURSING HOME PHCY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033145735
- **Authorized official:** EDWARD AHRENS R.PH (SUPERVISING PHARMACIST)
- **Authorized official phone:** (212) 879-1600

## Contact information

- **Practice address:** 211 E 79TH ST, NEW YORK, NY 10021-0819
- **Practice address phone:** (212) 879-1600
- **Practice address fax:** (212) 879-4594
- **Mailing address:** 211 E 79TH ST, NEW YORK, NY 10021-0819
- **Mailing address phone:** (212) 879-1600
- **Mailing address fax:** (212) 879-4594

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | 025580 | NY | Yes |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 06/24/2006
- **Last updated:** 12/16/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00310421 | — | NY |
| 01 | — | 3337979 | OTHER ID NUMBER-COMMERCIAL NUMBER | — |