ISLAND REHABILITATIVE SERVICES CORP
Ambulatory Health at Fanning St, Staten Island, NY

License number
New York 7004204R
Category
Ambulatory Health
Type
End-Stage Renal Disease (ESRD) Treatment
Owner
Name: MR. DOMINIC LICCIARDI
Title: ADMINISTRATOR
Phone: (718) 987-5942
Address
Address
25 Fanning St, Staten Island, NY 10314
National Provider ID: 1669453502
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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Bridge Realty Corp.C/O Island Rehabilitative Services, Corp

97 New Dorp Ln, Staten Island, NY 10306

Industry:
Services-Misc
Nephrologys:
M. Kleiner (Principal),Catherine Hudgens Nurse Practitioner, inactive,Edward M. Epstein Nephrology, inactive,...

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