Healthcare Provider Details

I. General information

NPI: 1548705775
Provider Name (Legal Business Name): YERTLE OPERATIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2016
Last Update Date: 12/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 ROBERT R KASIN WAY
BEACON NY
12508-1559
US

IV. Provider business mailing address

3008 AVENUE J
BROOKLYN NY
11210-3838
US

V. Phone/Fax

Practice location:
  • Phone: 718-697-7523
  • Fax:
Mailing address:
  • Phone: 718-697-7523
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: RICHARD PLATSCHEK
Title or Position: MANAGING MEMBER
Credential:
Phone: 718-697-7523