Healthcare Provider Details

I. General information

NPI: 1538595962
Provider Name (Legal Business Name): SCHAFFER EXTENDED CARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2013
Last Update Date: 09/29/2020
Certification Date: 09/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 GUION PL
NEW ROCHELLE NY
10801-5502
US

IV. Provider business mailing address

16 GUION PL
NEW ROCHELLE NY
10801-5502
US

V. Phone/Fax

Practice location:
  • Phone: 914-632-5000
  • Fax:
Mailing address:
  • Phone: 914-632-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number032395
License Number StateNY

VIII. Authorized Official

Name: RANDI L KOHN
Title or Position: AVP
Credential:
Phone: 718-920-6080