Island Rehab Services - Clove Lakes Extension
Name
Island Rehab Services - Clove Lakes Extension
Director
Morton J. Kleiner, M.D.
Expiration Date
Phone Number
(347) 671-8399
UID (Facility ID - Site ID)
X562-0000
Site ID
0000
City
Staten Island
CLIA Number
33D2149569
Street Address
25 Fanning Street
State
NY
Zip Code
10314
County
Richmond
Country
United States
Fax Number
(347) 671-8398
Primary Contact
Dominic Licciardi
Contact Phone Number
(718) 987-5942
Certificate Type
WAIVER
Tests
Glucose
Facility ID
X562