Healthcare Provider Details

I. General information

NPI: 1528610433
Provider Name (Legal Business Name): PINNACLE GROUP OF HUDSON VALLEY II LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2019
Last Update Date: 11/01/2022
Certification Date: 11/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1142 MAIN ST
SANFORD ME
04073-3614
US

IV. Provider business mailing address

3 VILLA LN
MONSEY NY
10952-1021
US

V. Phone/Fax

Practice location:
  • Phone: 207-324-2273
  • Fax:
Mailing address:
  • Phone: 845-596-6633
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: ISRAEL NACHFOLGER
Title or Position: CEO
Credential: RN, NREMTP
Phone: 845-596-6633