Healthcare Provider Details

I. General information

NPI: 1336134915
Provider Name (Legal Business Name): H A SCHACHTER ERNEST DICKER ETAL SHORE VIEW NURSING HOME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2005
Last Update Date: 07/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2865 BRIGHTON 3RD ST
BROOKLYN NY
11235
US

IV. Provider business mailing address

2865 BRIGHTON 3RD ST
BROOKLYN NY
11235-6762
US

V. Phone/Fax

Practice location:
  • Phone: 718-891-4400
  • Fax: 718-891-5031
Mailing address:
  • Phone: 718-891-4400
  • Fax: 718-891-5031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number7001342N
License Number StateNY

VIII. Authorized Official

Name: MR. HOWARD SMALL
Title or Position: ADMINISTRATOR
Credential:
Phone: 718-891-4400