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NPI Code Detail

MEDICARE: NORTHERN MANHATTAN NURSING HOME INC

MEDICARE: NORTHERN MANHATTAN NURSING HOME INC
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 Facility7002355NY

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 : 1609879915
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTHERN MANHATTAN NURSING HOME INC
Provider Business Mailing Address
First Line : 116 E 125TH ST
Second Line :
City : NEW YORK
State : NY
Zip : 10035-1612
Country : US
Telephone Number : 212-426-1284
Fax Number : 212-427-9509
Provider Business Practice Location Address
First Line : 116 E 125TH ST
Second Line :
City : NEW YORK
State : NY
Zip : 10035-1612
Country : US
Telephone Number : 212-426-1284
Fax Number : 212-427-9509
Authorized Official
Title or Position : CONTROLLER
Name : MR. MARTY LOEB
Credential :
Telephone Number : 212-426-1284
Provider Enumeration Date : 05/31/2005
Last Update Date : 02/11/2016

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