1639221658 NPI number — HEBREW HOME FOR THE AGED AT RIVERDALE

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 1639221658 NPI number — HEBREW HOME FOR THE AGED AT RIVERDALE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
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:
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:
1639221658
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
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:
718-581-1000
Provider Business Mailing Address Fax Number:
718-796-7534

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5901 PALISADE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10471-1205
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-581-1000
Provider Business Practice Location Address Fax Number:
718-796-7534
Provider Enumeration Date:
01/18/2007

Additional Information

Authorized Official

Authorized Official Last Name:
RAMDASS
Authorized Official First Name:
SAVITA
Authorized Official Middle Name:
D
Authorized Official Title or Position:
BILLING MANAGER
Authorized Official Telephone Number:
718-581-1712

Provider Taxonomy Codes

  • Taxonomy code: 314000000X , with the licence number:  01023156 , 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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