Healthcare Provider Details

I. General information

NPI: 1811464878
Provider Name (Legal Business Name): ES RECEIVER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2018
Last Update Date: 10/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1175 DELAWARE AVE
BUFFALO NY
14209-1401
US

IV. Provider business mailing address

1720 WHITESTONE EXPY STE 500
WHITESTONE NY
11357-3021
US

V. Phone/Fax

Practice location:
  • Phone: 718-215-6000
  • Fax:
Mailing address:
  • Phone: 718-215-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. ERIC ROGERS
Title or Position: CFO
Credential: CPA
Phone: 718-215-6000