MEDICARE: MARNC OPERATING 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

General Provider Information

NPI Number	:	1255830162
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARNC OPERATING LLC

Provider Business Mailing Address
First Line	:	20 WOOD CT
Second Line	:
City	:	TARRYTOWN
State	:	NY
Zip	:	10591-3108
Country	:	US
Telephone Number	:	914-597-7600
Fax Number	:

Provider Business Practice Location Address
First Line	:	89 GROVE ST
Second Line	:
City	:	MASSENA
State	:	NY
Zip	:	13662-2615
Country	:	US
Telephone Number	:	914-597-7600
Fax Number	:

Authorized Official
Title or Position	:	FINANCE
Name	:	ABE MOSTOFSKY
Credential	:
Telephone Number	:	347-832-6899

Provider Enumeration Date	:	02/06/2018
Last Update Date	:	12/24/2024

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Directions to “MARNC OPERATING LLC ” Practice Location

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