Healthcare Provider Details

I. General information

NPI: 1730429788
Provider Name (Legal Business Name): LAKELAND OPERATIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2013
Last Update Date: 07/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 5TH AVE
HASKELL NJ
07420-1075
US

IV. Provider business mailing address

14C 53RD ST
BROOKLYN NY
11232-2644
US

V. Phone/Fax

Practice location:
  • Phone: 718-567-0400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: CHAVIE KATZ
Title or Position: BILLING MANAGER
Credential:
Phone: 718-567-0400