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NPI Code Detail

MEDICARE: HEBREW HOME FOR THE AGED AT RIVERDALE

MEDICARE: HEBREW HOME FOR THE AGED AT RIVERDALE
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 Facility7000302NNY

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 : 1205939667
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEBREW HOME FOR THE AGED AT RIVERDALE
Provider Business Mailing Address
First Line : 5901 PALISADE AVE
Second Line :
City : BRONX
State : NY
Zip : 10471-1205
Country : US
Telephone Number : 718-581-1313
Fax Number : 187-709-4277
Provider Business Practice Location Address
First Line : 5901 PALISADE AVE
Second Line :
City : BRONX
State : NY
Zip : 10471-1205
Country : US
Telephone Number : 718-581-1313
Fax Number : 718-709-4277
Authorized Official
Title or Position : INTERIM CFO
Name : CARL WILLNER
Credential :
Telephone Number : 718-581-1313
Provider Enumeration Date : 09/07/2006
Last Update Date : 04/07/2025

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Practice Location Address:
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10471-1205
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Practice Fax:
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1699751974 — DR. DASEN M BRAJKOVIC MD
Practice Location Address:
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Practice Fax:
1013026863 — PALISADE NURSING HOME CO INC.
Practice Location Address:
5901 PALISADE AVE
BRONX, NY
10471-1205
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1639221658 — HEBREW HOME FOR THE AGED AT RIVERDALE
Practice Location Address:
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BRONX, NY
10471-1205
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1124211610 — ELDERSERVE SOCIAL MODEL DAY CARE
Practice Location Address:
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Directions to “HEBREW HOME FOR THE AGED AT RIVERDALE ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.