Healthcare Provider Details

I. General information

NPI: 1912270455
Provider Name (Legal Business Name): RSRNC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2012
Last Update Date: 02/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 N MAIN ST
CASTLETON NY
12033-1006
US

IV. Provider business mailing address

1 HILLCREST CTR SUITE #225
SPRING VALLEY NY
10977-3740
US

V. Phone/Fax

Practice location:
  • Phone: 518-732-7617
  • Fax: 518-732-4732
Mailing address:
  • Phone: 845-371-8100
  • Fax: 845-371-0010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number4124300N
License Number StateNY

VIII. Authorized Official

Name: EFRAIM STEIF
Title or Position: MEMBER
Credential:
Phone: 845-371-8100