Healthcare Provider Details

I. General information

NPI: 1134263155
Provider Name (Legal Business Name): PARKWAY HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2007
Last Update Date: 05/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

96 PARKWAY
ROCHELLE PARK NJ
07662-4200
US

IV. Provider business mailing address

96 PARKWAY
ROCHELLE PARK NJ
07662
US

V. Phone/Fax

Practice location:
  • Phone: 718-567-0400
  • Fax: 718-567-0600
Mailing address:
  • Phone: 718-567-0400
  • Fax: 718-567-0600

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: MS. CHAVIE KATZ
Title or Position: BILLING SUPERVISOR
Credential:
Phone: 718-567-0400