Healthcare Provider Details

I. General information

NPI: 1093144024
Provider Name (Legal Business Name): ESSEX OPERATIONS ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2013
Last Update Date: 10/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81 PARK ST
ELIZABETHTOWN NY
12932-0217
US

IV. Provider business mailing address

4770 WHITE PLAINS RD
BRONX NY
10470-1104
US

V. Phone/Fax

Practice location:
  • Phone: 518-873-3500
  • Fax: 518-873-3539
Mailing address:
  • Phone: 718-931-9700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number1552300N
License Number StateNY

VIII. Authorized Official

Name: MR. KENNETH ROZENBERG
Title or Position: MEMBER
Credential:
Phone: 718-931-9700