Healthcare Provider Details

I. General information

NPI: 1164811220
Provider Name (Legal Business Name): URNC OPERATING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2015
Last Update Date: 06/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2535 GENESEE ST
UTICA NY
13501-6251
US

IV. Provider business mailing address

20 WOOD CT
TARRYTOWN NY
10591-3108
US

V. Phone/Fax

Practice location:
  • Phone: 315-797-1230
  • Fax:
Mailing address:
  • Phone: 914-597-7630
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number3202316N
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License Number320231010
License Number StateNY

VIII. Authorized Official

Name: ISRAEL OSTROVITSKY
Title or Position: CONTROLLER
Credential:
Phone: 914-597-7631