1578568374 NPI number — SENECA NURSING AND REHABILITATION

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578568374 NPI number — SENECA NURSING AND REHABILITATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SENECA NURSING AND REHABILITATION
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:
6
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:
1578568374
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/04/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
740 EAST AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROCHESTER
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14607-2107
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
585-244-0410
Provider Business Mailing Address Fax Number:
585-244-1374

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
200 DOUGLAS DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WATERLOO
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13165-1645
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-539-9202
Provider Business Practice Location Address Fax Number:
315-539-3495
Provider Enumeration Date:
06/17/2005

Additional Information

Authorized Official

Authorized Official Last Name:
REED
Authorized Official First Name:
BRIGETT
Authorized Official Middle Name:
M
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
585-244-0410

Provider Taxonomy Codes

  • Taxonomy code: 261QR0400X , with the licence number:  4921303 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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