Healthcare Provider Details

I. General information

NPI: 1053337865
Provider Name (Legal Business Name): ROSA COPLONJEWISH HOME AND INFIRMARY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 11/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 N FOREST RD
GETZVILLE NY
14068-1527
US

IV. Provider business mailing address

2700 N FOREST RD
GETZVILLE NY
14068-1527
US

V. Phone/Fax

Practice location:
  • Phone: 716-639-3311
  • Fax: 716-639-3309
Mailing address:
  • Phone: 716-639-3311
  • Fax: 716-639-3309

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNY

VIII. Authorized Official

Name: MR. ROBERT T. MAYER
Title or Position: PRESIDENT/CEO
Credential:
Phone: 716-639-3311