Healthcare Provider Details

I. General information

NPI: 1881622785
Provider Name (Legal Business Name): MIDWAY NURSING HOME, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6995 QUEENS MIDTOWN EXPY EXPRESSWAY
MASPETH NY
11378-1922
US

IV. Provider business mailing address

6995 QUEENS MIDTOWN EXPY EXPRESSWAY
MASPETH NY
11378-1922
US

V. Phone/Fax

Practice location:
  • Phone: 718-961-1212
  • Fax: 718-461-9484
Mailing address:
  • Phone: 718-961-1212
  • Fax: 718-461-9484

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. MOSHE KALTER
Title or Position: PRESIDENT
Credential:
Phone: 718-961-1212