MEDICARE: SCHENECTADY NURSING AND REHABILITATION CENTER, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	4601306N	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053308205
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCHENECTADY NURSING AND REHABILITATION CENTER, LLC

Provider Business Mailing Address
First Line	:	1940 HAMBURG ST
Second Line	:
City	:	SCHENECTADY
State	:	NY
Zip	:	12304-4791
Country	:	US
Telephone Number	:	518-370-5051
Fax Number	:	518-374-6271

Provider Business Practice Location Address
First Line	:	1940 HAMBURG ST
Second Line	:
City	:	SCHENECTADY
State	:	NY
Zip	:	12304-4791
Country	:	US
Telephone Number	:	518-370-5051
Fax Number	:	518-374-6271

Authorized Official
Title or Position	:	C.E.O.
Name	:	PATRICK RICHARD MARTONE
Credential	:
Telephone Number	:	518-346-9640

Provider Enumeration Date	:	10/03/2005
Last Update Date	:	01/16/2009

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