1033236211 NPI number — AMSTERDAM NURSING HOME CORPORATION

Table of content: (NPI 1033236211)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033236211 NPI number — AMSTERDAM NURSING HOME CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AMSTERDAM NURSING HOME CORPORATION
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:
1033236211
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/09/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1060 AMSTERDAM AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10025-1715
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-316-7700
Provider Business Mailing Address Fax Number:
212-662-1793

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1060 AMSTERDAM AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10025-1715
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-316-7700
Provider Business Practice Location Address Fax Number:
212-662-1793
Provider Enumeration Date:
03/23/2007

Additional Information

Authorized Official

Authorized Official Last Name:
PANCIRER
Authorized Official First Name:
MARK
Authorized Official Middle Name:
Authorized Official Title or Position:
VICE PRESIDENT C.F.O.
Authorized Official Telephone Number:
212-734-6621

Provider Taxonomy Codes

  • Taxonomy code: 314000000X , 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: 00314594 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: DTP01958263 . This is a "SHP MNGD MCAD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: A1011800 . This is a "OXFORD PROVIDER NUMBER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 335570 . This is a "HIP PROVIDER NUMBER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 7002356N , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: DTP01958263 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 007894 . This is a "BCBS PROVIDER NUMBER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 7100141 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 01958263 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0803121 . This is a "AETNA HMO PROVIDER NUMBER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 7100141 . This is a "EVERCARE PROVIDER NUMBER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 133734710 . This is a "ELDERPLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 5309499 . This is a "AETNA PROVIDER NUMBER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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