Healthcare Provider Details

I. General information

NPI: 1366847451
Provider Name (Legal Business Name): ATLANTIS OPERATING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2014
Last Update Date: 10/31/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 SAINT EDWARDS ST ADMINISTRATION
BROOKLYN NY
11201-3904
US

IV. Provider business mailing address

140 SAINT EDWARDS ST ADMINISTRATION
BROOKLYN NY
11201-3904
US

V. Phone/Fax

Practice location:
  • Phone: 718-858-6400
  • Fax: 718-254-0375
Mailing address:
  • Phone: 718-858-6400
  • Fax: 718-254-0375

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: MRS. DEVORAH FRIEDMAN
Title or Position: OWNER
Credential:
Phone: 718-858-6400