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General NPI Number Information
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NPI Number | 1053523027
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Entity Type | Organization
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Legal Business Name | SERVANTS OF RELIEF FOR INCURABLE CANCER
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 71 JACKSON ST
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City | NEW YORK
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State | NY
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Zip | 10002-8201
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Country | US
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Telephone | 212-677-8132
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Fax | 212-982-3485
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Provider Business Mailing Address
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Address Line | 71 JACKSON ST
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City | NEW YORK
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State | NY
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Zip | 10002-8201
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Country | US
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Telephone | 212-677-8132
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Fax | 212-982-3485
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Authorized Official
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Title or Position | VICE-PRESIDENT
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Name | SR. MARY FLORENCE GILMORE
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Credential | R.N.
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Telephone | 212-677-8132
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 7002307N
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License Number State | NY
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