Healthcare Provider Details

I. General information

NPI: 1740278910
Provider Name (Legal Business Name): NEW YORK CONGREGATIONAL NURSING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2005
Last Update Date: 08/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 LINDEN BLVD
BROOKLYN NY
11226-3302
US

IV. Provider business mailing address

135 LINDEN BLVD
BROOKLYN NY
11226-3302
US

V. Phone/Fax

Practice location:
  • Phone: 718-693-6060
  • Fax: 718-284-0349
Mailing address:
  • Phone: 718-693-6060
  • Fax: 718-284-0349

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number7001309N
License Number StateNY

VIII. Authorized Official

Name: MS. MAUREEN MESSA
Title or Position: CFO
Credential:
Phone: 718-284-0039