Healthcare Provider Details

I. General information

NPI: 1417338005
Provider Name (Legal Business Name): HOTEL BENEFIT FUNDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2015
Last Update Date: 06/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 MAIN ST APT 1432
NEW YORK NY
10044-0036
US

IV. Provider business mailing address

625 MAIN ST APT 1432
NEW YORK NY
10044-0036
US

V. Phone/Fax

Practice location:
  • Phone: 917-346-9708
  • Fax:
Mailing address:
  • Phone: 917-346-9708
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number281387-1
License Number StateNY

VIII. Authorized Official

Name: MS. MATER ORIOSTE-VICTORIA
Title or Position: SUPERVISOR
Credential:
Phone: 212-586-6400