Healthcare Provider Details

I. General information

NPI: 1538195268
Provider Name (Legal Business Name): ISABELLA GERIATRIC CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2006
Last Update Date: 01/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 AUDUBON AVE
NEW YORK NY
10040-3403
US

IV. Provider business mailing address

515 AUDUBON AVE
NEW YORK NY
10040-3403
US

V. Phone/Fax

Practice location:
  • Phone: 212-342-9427
  • Fax: 212-740-3951
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number027340
License Number StateNY

VIII. Authorized Official

Name: MICHELE ZERENER
Title or Position: DIRECTOR OF PHARMACY
Credential:
Phone: 212-342-9427