Organization
STATEN ISLAND CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHANNON M BARBACK (MEDICAL RECORDS)
(718) 448-9000
Entity
Organization
Contact information
Practice address
200 LAFAYETTE AVE, STATEN ISLAND, NY 10301-1219
(718) 448-9000
(718) 448-9184
Mailing address
200 LAFAYETTE AVE, STATEN ISLAND, NY 10301-1219
(718) 448-9000
(718) 448-9184
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
7004314N
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00314690
—
NY
Enumeration date
10/06/2005
Last updated
02/10/2012
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