ISLAND REHABILITATIVE SERVICES CORP is an end-stage renal disease (esrd) treatment clinic center in Staten Island, NY. ISLAND REHABILITATIVE SERVICES CORP NPI is 1669453502. The provider is registered as an organization entity type.
The provider's business location address is:
25 FANNING ST
STATEN ISLAND, NY
ZIP 10314-307
Phone: (347) 671-8399
Fax: (347) 671-8398
The provider's authorized official is Dominic Licciardi .
The authorized official title is Administrator and has the following contact phone number (718) 987-5942.
The CLIA number assigned to this NPI record is 33D2149569 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 11/8/2005 and was last updated on 9/28/2011.