Healthcare Provider Details

I. General information

NPI: 1306016548
Provider Name (Legal Business Name): SENIOR PROJECTS OF RAVENA,INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2008
Last Update Date: 03/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 BRUNO BLOUVARD
RAVENA NY
12143
US

IV. Provider business mailing address

PO BOX 142
RAVENA NY
12143-0142
US

V. Phone/Fax

Practice location:
  • Phone: 518-756-8593
  • Fax: 518-756-9671
Mailing address:
  • Phone: 518-756-8593
  • Fax: 518-756-9671

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number StateNY

VIII. Authorized Official

Name: MS. TERRI DAWN ALBANO
Title or Position: DIRECTOR
Credential:
Phone: 518-756-8593