Healthcare Provider Details

I. General information

NPI: 1881559037
Provider Name (Legal Business Name): THE TERRACE AT GLEN EDDY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 ASCOT LN
NISKAYUNA NY
12309-4962
US

IV. Provider business mailing address

1 ASCOT LN
NISKAYUNA NY
12309-4962
US

V. Phone/Fax

Practice location:
  • Phone: 518-280-8361
  • Fax:
Mailing address:
  • Phone: 518-280-8361
  • Fax: 518-280-8379

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: JACQUELINE B REILLY
Title or Position: RESIDENT SERVICES MANAGER
Credential: RN
Phone: 518-280-8360