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General NPI Number Information
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NPI Number | 1083600969
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Entity Type | Organization
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Legal Business Name | ST. JEROMES HEALTH SERVICES CORPORATION
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Dates
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Enumeration Date | 09/26/2005
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1740 84TH ST
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City | BROOKLYN
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State | NY
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Zip | 11214-2825
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Country | US
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Telephone | 718-232-3666
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Fax | 718-259-9180
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Provider Business Mailing Address
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Address Line | 1740 84TH ST
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City | BROOKLYN
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State | NY
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Zip | 11214-2825
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Country | US
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Telephone | 718-232-3666
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Fax | 718-259-9180
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. LISA DENIS-SCHIANO
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Credential | LNHA
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Telephone | 718-232-3666
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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 |
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License Number State | NY
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