Healthcare Provider Details

I. General information

NPI: 1275608390
Provider Name (Legal Business Name): JEWISH HOME LIFECARE SARAH NEUMAN CENTER WESTCHESTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2006
Last Update Date: 04/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

845 PALMER AVE ATTN MEDICAL DEPARTMENT
MAMARONECK NY
10543-2406
US

IV. Provider business mailing address

845 PALMER AVE ATTN MEDICAL DEPARTMENT
MAMARONECK NY
10543-2406
US

V. Phone/Fax

Practice location:
  • Phone: 914-864-5856
  • Fax:
Mailing address:
  • Phone: 914-864-5856
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number5909302N
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5909302N
License Number StateNY

VIII. Authorized Official

Name: AUDREY WEINER
Title or Position: CEO
Credential: DSW
Phone: 212-870-4600