Healthcare Provider Details

I. General information

NPI: 1245227859
Provider Name (Legal Business Name): SEPHARDIC HOME FOR THE AGED, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2005
Last Update Date: 11/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2266 CROPSEY AVE
BROOKLYN NY
11214-5706
US

IV. Provider business mailing address

2266 CROPSEY AVE
BROOKLYN NY
11214-5706
US

V. Phone/Fax

Practice location:
  • Phone: 718-266-6100
  • Fax: 718-363-2865
Mailing address:
  • Phone: 718-266-6100
  • Fax: 718-363-2865

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number7001303N
License Number StateNY

VIII. Authorized Official

Name: MR. ARTHUR E NEW
Title or Position: CEO
Credential:
Phone: 718-266-6100