Healthcare Provider Details

I. General information

NPI: 1033200100
Provider Name (Legal Business Name): VERRAZANO NURSING HOME INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 CASTLETON AVENUE
STATEN ISLAND NY
10301
US

IV. Provider business mailing address

100 CASTLETON AVENUE
STATEN ISLAND NY
10301
US

V. Phone/Fax

Practice location:
  • Phone: 718-273-1300
  • Fax: 718-442-0113
Mailing address:
  • Phone: 718-273-1300
  • Fax: 718-442-0113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number7004320N
License Number StateNY

VIII. Authorized Official

Name: MR. DAVID GELLEY
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 718-273-1300