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JEFFERSON REHABILITATION CENTER NPI 1295941912


NPI Information

NPI: 1295941912
Provider Name: JEFFERSON REHABILITATION CENTER
Classification: Clinic/Center - 261QD1600X
Entity Type: Organization

Specialization: Developmental Disabilities

Address:
420 GAFFNEY DR
WATERTOWN, NY
ZIP 13601
Phone: (315) 788-2730
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JEFFERSON REHABILITATION CENTER is a developmental disabilities clinic center in Watertown, NY. The provider is an entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.). JEFFERSON REHABILITATION CENTER NPI is 1295941912. The provider is registered as an organization entity type.

The provider's business location address is:

420 GAFFNEY DR
WATERTOWN, NY
ZIP 13601-823
Phone: (315) 788-2730
Fax: (315) 788-8557

The provider's authorized official is Daniel E. Stern .
The authorized official title is Executive Director and has the following contact phone number (315) 788-2730.

The enumeration date for this NPI number is 5/16/2007 and was last updated on 8/22/2020.


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
1261QD1600XClinic/CenterDevelopmental Disabilities7642300NEW 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
100618960MEDICAIDNEW 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: 11/14/2023

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