Healthcare Provider Details

I. General information

NPI: 1801301254
Provider Name (Legal Business Name): FSNR SNF LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2017
Last Update Date: 12/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1555 ROCKAWAY PKWY
BROOKLYN NY
11236-4001
US

IV. Provider business mailing address

1535 ROCKAWAY PKWY
BROOKLYN NY
11236-4001
US

V. Phone/Fax

Practice location:
  • Phone: 718-927-6346
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: NATHAN ZELCER
Title or Position: CONTROLLER
Credential:
Phone: 718-927-6346