Healthcare Provider Details

I. General information

NPI: 1215557988
Provider Name (Legal Business Name): THE PEARL NURSING CENTER OF ROCHESTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2020
Last Update Date: 04/22/2020
Certification Date: 04/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1335 PORTLAND AVE
ROCHESTER NY
14621-2706
US

IV. Provider business mailing address

99 W HAWTHORNE AVE STE 508
VALLEY STREAM NY
11580-6101
US

V. Phone/Fax

Practice location:
  • Phone: 585-544-4000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. GABRIEL PLATSCHEK
Title or Position: MEMBER
Credential:
Phone: 646-675-1304