Clove Lakes Rehabilitation and Outpatient Services

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

CLOVE LAKES REHABILITATION AND OUTPATIENT SERVICES

Practice address

25 Fanning St
Staten Island, NY 10314-5307

Phone

(718) 289-7878

NPI assigned

Jun 13, 2006

Organization subpart

Yes

Parent organization

CLOVE LAKES HEALTH CARE AND REHABILITATION CENTER, INC.As reported in NPPES

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

Authorized official

Name

Mary Beth Francis

Title

Administrator

Phone

(718) 289-7034

Specialties & licenses 3

Addresses

Other identifiers 1

Part of

Clove Lakes Health Care

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Clove Lakes Health Care and Rehabilitation Center, Inc.

  • Skilled Nursing Facility
  • Staten Island, NY
  • NPI 1417952417
  NPPES parent name

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184630400000",
    "number": "1659314193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 FANNING ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103145307",
            "telephone_number": "718-289-7890",
            "fax_number": "718-761-8701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 FANNING ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103145307",
            "telephone_number": "718-289-7878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLOVE LAKES REHABILITATION AND OUTPATIENT SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CLOVE LAKES HEALTH CARE AND REHABILITATION CENTER, INC.",
        "enumeration_date": "2006-06-13",
        "last_updated": "2007-07-17",
        "status": "A",
        "authorized_official_last_name": "FRANCIS",
        "authorized_official_first_name": "MARY BETH",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "718-289-7034"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01876104",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary E Clooeny, MSW
• Clove Lake Cars
• Clove Lakes ENT PC
• Clove Lakes Family Dental PLLC
• Clove Lakes Health Care and Rehabilitation Center, Inc.
• Clove Lakes SNF Operations LLC
• Clove RX LLC
• Clove Urology,PC
• Club Mental Health Counseling Services, P.C.
• Douglas Clyburn, R.N.

• Physical Therapist in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2007; 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.