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NPI Code Detail

MEDICARE: KFG OPERATING I, LLC

MEDICARE: KFG OPERATING I, 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
1314000000XSkilled Nursing Facility7001377NNY

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 : 1972893683
Entity Type Code : Organization
Provider Name (Legal Business Name) : KFG OPERATING I, LLC
Provider Business Mailing Address
First Line : 155 DEAN ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11217-2213
Country : US
Telephone Number : 718-694-6700
Fax Number : 718-694-6710
Provider Business Practice Location Address
First Line : 155 DEAN ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11217-2213
Country : US
Telephone Number : 718-694-6700
Fax Number : 718-694-6710
Authorized Official
Title or Position : MANAGING MEMBER
Name : CHARLES-EDOUARD GROS
Credential :
Telephone Number : 718-360-8083
Provider Enumeration Date : 04/14/2011
Last Update Date : 04/14/2011

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Directions to “KFG OPERATING I, LLC ” Practice Location

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