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NPI Code Detail

MEDICARE: SOMERS MANOR NURSING HOME, INC

MEDICARE: SOMERS MANOR 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 Facility5966300NNY

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 : 1730174624
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOMERS MANOR NURSING HOME, INC
Provider Business Mailing Address
First Line : 189 ROUTE 100
Second Line :
City : SOMERS
State : NY
Zip : 10589-2811
Country : US
Telephone Number : 914-232-5101
Fax Number :
Provider Business Practice Location Address
First Line : 189 ROUTE 100
Second Line :
City : SOMERS
State : NY
Zip : 10589-2811
Country : US
Telephone Number : 914-232-5101
Fax Number :
Authorized Official
Title or Position : VICE PRESIDENT
Name : JANICE DEPP
Credential :
Telephone Number : 914-232-5107
Provider Enumeration Date : 09/16/2005
Last Update Date : 08/22/2020

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Directions to “SOMERS MANOR NURSING HOME, INC ” Practice Location

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