MEDICARE: MONTEFIORE NYACK HOSPITAL

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	251E00000X	Home Health Agency	4324601	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	:	1538180559
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MONTEFIORE NYACK HOSPITAL

Provider Business Mailing Address
First Line	:	160 N MIDLAND AVE
Second Line	:
City	:	NYACK
State	:	NY
Zip	:	10960-1912
Country	:	US
Telephone Number	:	845-638-8714
Fax Number	:	845-638-8805

Provider Business Practice Location Address
First Line	:	17 SQUADRON BLVD
Second Line	:
City	:	NEW CITY
State	:	NY
Zip	:	10956-5214
Country	:	US
Telephone Number	:	845-638-8714
Fax Number	:	845-638-8805

Authorized Official
Title or Position	:	ADMINISTRATOR HOME CARE
Name	:	MS. COLLEEN NUNES
Credential	:	OTR/L
Telephone Number	:	845-348-8714

Provider Enumeration Date	:	07/22/2006
Last Update Date	:	11/08/2024

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Directions to “MONTEFIORE NYACK HOSPITAL ” Practice Location

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