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NPI Code Detail

MEDICARE: DAUGHTERS OF JACOB NURSING HOME CO

MEDICARE: DAUGHTERS OF JACOB NURSING HOME CO
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
1314000000XSkilled Nursing Facility7000342NNY

Other Identifiers

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

General Provider Information

NPI Number : 1194727156
Entity Type Code : Organization
Provider Name (Legal Business Name) : DAUGHTERS OF JACOB NURSING HOME CO
Provider Business Mailing Address
First Line : 1160 TELLER AVE
Second Line :
City : BRONX
State : NY
Zip : 10456-4145
Country : US
Telephone Number : 718-293-1500
Fax Number : 718-992-7074
Provider Business Practice Location Address
First Line : 1160 TELLER AVE
Second Line :
City : BRONX
State : NY
Zip : 10456-4145
Country : US
Telephone Number : 718-293-1500
Fax Number : 718-992-7074
Authorized Official
Title or Position : CEO
Name : KENNETH ROZENBERG
Credential :
Telephone Number : 718-931-9700
Provider Enumeration Date : 06/02/2005
Last Update Date : 11/15/2013

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Directions to “DAUGHTERS OF JACOB NURSING HOME CO ” Practice Location

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