1720443047 NPI number — THE HEBREW HOME FOR THE AGED AT RIVERDALE

Table of content: (NPI 1720443047)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720443047 NPI number — THE HEBREW HOME FOR THE AGED AT RIVERDALE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE HEBREW HOME FOR THE AGED AT RIVERDALE
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:
1720443047
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/31/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5901 PALISADE AVENUE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RIVERDALE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10471
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-581-1313
Provider Business Mailing Address Fax Number:
718-709-4277

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5901 PALISADE AVENUE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RIVERDALE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10471
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-581-1313
Provider Business Practice Location Address Fax Number:
718-709-4277
Provider Enumeration Date:
12/31/2015

Additional Information

Authorized Official

Authorized Official Last Name:
WILLNER
Authorized Official First Name:
CARL
Authorized Official Middle Name:
Authorized Official Title or Position:
VICE PRESIDENT, FINANCE
Authorized Official Telephone Number:
718-581-1313

Provider Taxonomy Codes

  • Taxonomy code: 261QR0400X , 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)

  • Identifier: 00310316 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com