Healthcare Provider Details

I. General information

NPI: 1841613163
Provider Name (Legal Business Name): SGRNC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2014
Last Update Date: 05/03/2022
Certification Date: 05/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2266 CROPSEY AVE
BROOKLYN NY
11214
US

IV. Provider business mailing address

691 92ND ST FL 2
BROOKLYN NY
11228-3619
US

V. Phone/Fax

Practice location:
  • Phone: 718-266-6100
  • Fax: 347-269-3146
Mailing address:
  • Phone: 347-560-2238
  • Fax: 347-269-3146

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: MR. SOLOMON RUBIN
Title or Position: CEO
Credential:
Phone: 347-560-2238