OrganizationActive
Island Rehabilitative Services/B'Klyn
NPI 1790779114 · End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Brooklyn, NY
Provider details
- NPI number
- 1790779114
- Entity type
- Organization
- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Dominic Licciardi, Administrator(718) 437-1594
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
5918-5924 13th Ave
Island Rehabilitative Services/B'Klyn
Brooklyn, NY 11219
Phone: (718) 437-1594
Fax: (718) 437-5092
Street-level locationGet directions
Mailing address
2031-10 Forest Ave
Staten Island, NY 10303-1796
Registry dates
- Enumerated
- 2005-08-31
- Last updated
- 2022-07-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.