Healthcare Provider Details

I. General information

NPI: 1053308205
Provider Name (Legal Business Name): SCHENECTADY NURSING AND REHABILITATION CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2005
Last Update Date: 01/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1940 HAMBURG ST
SCHENECTADY NY
12304-4791
US

IV. Provider business mailing address

1940 HAMBURG ST
SCHENECTADY NY
12304-4791
US

V. Phone/Fax

Practice location:
  • Phone: 518-370-5051
  • Fax: 518-374-6271
Mailing address:
  • Phone: 518-370-5051
  • Fax: 518-374-6271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number4601306N
License Number StateNY

VIII. Authorized Official

Name: PATRICK RICHARD MARTONE
Title or Position: C.E.O.
Credential:
Phone: 518-346-9640