NPIMap

Organization Active NPI

Providence Rest Outpatient Rehabilitation

  • Skilled Nursing Facility
  • Bronx, NY
National Provider Identifier
1871754861
Registry record updated Jun 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
7000306N Issued in NY
Legal business name
PROVIDENCE REST OUTPATIENT REHABILITATION
Practice address
3304 Waterbury Ave
Bronx, NY 10465-1554
Phone
(718) 931-3000
NPI assigned
Jun 23, 2008
Last updated
Jun 23, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
PROVIDENCE REST NURSING HOMEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 23, 2008

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

Authorized official

Name
Mrs. Maria Spina
Title
Accounts Receivable Supervisor
Phone
(718) 931-3000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 7000306N NY Primary

Addresses

Primary practice location

3304 Waterbury Ave
Bronx, NY 10465-1554

Mailing address

3304 Waterbury Ave
Bronx, NY 10465-1554
Phone (718) 931-3000

National Provider Directory

National Provider Directory
Tax ID family
Providence Rest Adult Day Health Care4 organizations share this tax ID, including this one
Part of
Providence Rest Adult Day Health Care

Other organizations with this tax ID 3

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": "1214179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214179200000",
    "number": "1871754861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3304 WATERBURY AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104651554",
            "telephone_number": "718-931-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3304 WATERBURY AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104651554",
            "telephone_number": "718-931-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE REST OUTPATIENT REHABILITATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROVIDENCE REST NURSING HOME",
        "enumeration_date": "2008-06-23",
        "last_updated": "2008-06-23",
        "status": "A",
        "authorized_official_last_name": "SPINA",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "ACCOUNTS RECEIVABLE SUPERVISOR",
        "authorized_official_telephone_number": "718-931-3000",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NY",
            "license": "7000306N",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; 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.