Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Island Rehabilitative Services Corp

Organization End-Stage Renal Disease (ESRD) Treatment Clinic/Center · NPI 1669453502

Island Rehabilitative Services Corp is an End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Staten Island, New York. Medicare rates this dialysis facility 1 out of 5. Licensed in New York.

CMS rating
1 of 5
Licensed in
NY
In the registry since
2005
What do these letters mean?
Corp — Corporation
A form of business registration, not a clinical qualification.

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CMS quality rating

1 out of 5 — official dialysis facility rating from CMS Care Compare (CCN 332638)

Practice location Address checks out

25 Fanning St
Staten Island, NY 10314-5307
Phone: (347) 671-8399
Fax: (347) 671-8398
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

End-Stage Renal Disease (ESRD) Treatment Clinic/Center (primary) Taxonomy 261QE0700X · Licence 7004204R (NY)

Record details

NPI number1669453502
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationIsland Rehabilitative Services Corp
Authorized official Dominic Licciardi — Administrator · (718) 987-5942
NPI enumeratedNovember 8, 2005
Last updated in NPPESSeptember 28, 2011
Mailing address97 New Dorp Ln, Staten Island, NY 10306-2364

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