Healthcare Provider Details

I. General information

NPI: 1932215209
Provider Name (Legal Business Name): CLEARVIEW OPERATING CO. LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 07/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15715 19TH AVE
WHITESTONE NY
11357-3820
US

IV. Provider business mailing address

15715 19TH AVE
WHITESTONE NY
11357-3820
US

V. Phone/Fax

Practice location:
  • Phone: 718-746-0400
  • Fax: 718-746-9415
Mailing address:
  • Phone: 718-746-0400
  • Fax: 718-746-9415

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number7003404N
License Number StateNY

VIII. Authorized Official

Name: LIPA WERNER
Title or Position: CONTROLLER/MEMBER
Credential:
Phone: 718-931-9700