1588318547 NPI number — MCKEESPORT CENTER FOR NURSING AND REHAB LLC

Table of content: MRS. AMBER RAE LEE M.A., L.P.C. (NPI 1417367806)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588318547 NPI number — MCKEESPORT CENTER FOR NURSING AND REHAB LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MCKEESPORT CENTER FOR NURSING AND REHAB LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1588318547
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/09/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
34 LORD AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAWRENCE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11559-1324
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 8TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MCKEESPORT
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15132-2712
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-664-8860
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/09/2022

Additional Information

Authorized Official

Authorized Official Last Name:
LAHASKY
Authorized Official First Name:
EPHRAM
Authorized Official Middle Name:
Authorized Official Title or Position:
MEMBER
Authorized Official Telephone Number:
646-772-3668

Provider Taxonomy Codes

  • Taxonomy code: 314000000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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