Provider Demographics
NPI:1316251655
Name:VERSACARE, INC.
Entity type:Organization
Organization Name:VERSACARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:REDA
Authorized Official - Middle Name:S
Authorized Official - Last Name:SOLIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MBBCH, MD
Authorized Official - Phone:516-823-9500
Mailing Address - Street 1:128 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:LYNBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11563-3412
Mailing Address - Country:US
Mailing Address - Phone:516-823-9500
Mailing Address - Fax:516-823-9600
Practice Address - Street 1:8814 FOSTER AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-3211
Practice Address - Country:US
Practice Address - Phone:718-531-6300
Practice Address - Fax:718-345-0012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-28
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center