NPIMap

Organization Active NPI

Jefferson Rehabilitation Center

  • Early Intervention Provider Agency
  • Watertown, NY
National Provider Identifier
1043519986
Registry record updated Mar 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
License
016569-1 Issued in NY
Legal business name
JEFFERSON REHABILITATION CENTER
Practice address
420 Gaffney Dr
Watertown, NY 13601-1823
Phone
(315) 788-2730
Fax
(315) 788-8557
NPI assigned
Mar 17, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Howard Ganter
Title
Executive Director
Phone
(315) 788-2730

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X 016569-1 NY Primary

Addresses

Primary practice location

420 Gaffney Dr
Watertown, NY 13601-1823

Mailing address

420 Gaffney Dr
Watertown, NY 13601-1823

National Provider Directory

National Provider Directory
Tax ID family
Jefferson Rehabilitation Center8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1300320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300320000000",
    "number": "1043519986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 GAFFNEY DR",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136011823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 GAFFNEY DR",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136011823",
            "telephone_number": "315-788-2730",
            "fax_number": "315-788-8557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON REHABILITATION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-17",
        "last_updated": "2011-03-17",
        "status": "A",
        "authorized_official_last_name": "GANTER",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "315-788-2730"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NY",
            "license": "016569-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.