Healthcare Provider Details

I. General information

NPI: 1407847395
Provider Name (Legal Business Name): OXFORD NURSING HOME, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2005
Last Update Date: 06/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

144 S OXFORD ST
BROOKLYN NY
11217-1604
US

IV. Provider business mailing address

144 S OXFORD ST
BROOKLYN NY
11217-1604
US

V. Phone/Fax

Practice location:
  • Phone: 718-638-0360
  • Fax: 718-638-5800
Mailing address:
  • Phone: 718-638-0360
  • Fax: 718-638-5800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number00309811
License Number StateNY

VIII. Authorized Official

Name: MR. NORMAN MOTECHIN
Title or Position: ADMINISTRATOR
Credential:
Phone: 718-638-0360