MEDICARE: LFG 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	:	1679082960
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LFG OPERATING LLC

Provider Business Mailing Address
First Line	:	451 5TH AVE
Second Line	:
City	:	CEDARHURST
State	:	NY
Zip	:	11516-1537
Country	:	US
Telephone Number	:	347-273-5723
Fax Number	:

Provider Business Practice Location Address
First Line	:	5 CHURCH ST
Second Line	:
City	:	SPENCERPORT
State	:	NY
Zip	:	14559-1343
Country	:	US
Telephone Number	:	585-352-4810
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	GIORGIO MAYER
Credential	:
Telephone Number	:	718-486-2444

Provider Enumeration Date	:	09/29/2017
Last Update Date	:	01/17/2018

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Directions to “LFG OPERATING LLC ” Practice Location

Language	Start Address	Practice Location

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