Provider Type Icon

QUEENS BLVD EXT CARE FACILITY MANAGEMENT LLC NPI 1285034678


NPI Information

NPI: 1285034678
Provider Name: QUEENS BLVD EXT CARE FACILITY MANAGEMENT LLC

Doing Business As: QUEENS BLVD EXT CARE

Classification: Clinic/Center - 261QR0401X
Entity Type: Organization

Specialization: Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)

Address:
6111 QUEENS BLVD
WOODSIDE, NY
ZIP 11377
Phone: (718) 205-0298
Get Directions

QUEENS BLVD EXT CARE FACILITY MANAGEMENT LLC is a rehabilitation and comprehensive outpatient rehabilitation facility (corf) clinic center in Woodside, NY. QUEENS BLVD EXT CARE FACILITY MANAGEMENT LLC NPI is 1285034678. The provider is registered as an organization entity type.
The provider Is Doing Business As Queens Blvd Ext Care.

The provider's business location address is:

6111 QUEENS BLVD
WOODSIDE, NY
ZIP 11377-965
Phone: (718) 205-0298

The provider's authorized official is Joseph Malone .
The authorized official title is Cfo and has the following contact phone number (718) 205-0298.

The enumeration date for this NPI number is 9/4/2014 and was last updated on 9/4/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QR0401XClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)703410NNEW YORKYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1335791MEDICARE PINNEW YORK
22996110MEDICAIDNEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.