Healthcare Provider Details

I. General information

NPI: 1659368827
Provider Name (Legal Business Name): NORTH GATE HEALTH CARE FACILITY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2005
Last Update Date: 01/06/2025
Certification Date: 01/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7264 NASH RD
NORTH TONAWANDA NY
14120-1508
US

IV. Provider business mailing address

7264 NASH RD
NORTH TONAWANDA NY
14120-1508
US

V. Phone/Fax

Practice location:
  • Phone: 716-694-7700
  • Fax: 716-694-7720
Mailing address:
  • Phone: 716-694-7700
  • Fax: 716-694-7720

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number3160301N
License Number StateNY

VIII. Authorized Official

Name: MR. RALPH ROSSO
Title or Position: CFO
Credential:
Phone: 716-829-1554