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General NPI Number Information
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NPI Number | 1295770956
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Entity Type | Organization
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Legal Business Name | GOTHAM PER DIEM, INC
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Dates
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Enumeration Date | 06/18/2006
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Last Update Date | 10/31/2022
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Provider Practice Location Address
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Address Line | 90 BROAD ST - SUITE 1201
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City | NEW YORK
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State | NY
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Zip | 10004-2837
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Country | US
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Telephone | 212-477-3600
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Fax | 212-477-0795
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Provider Business Mailing Address
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Address Line | 90 BROAD ST - SUITE 1201
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City | NEW YORK
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State | NY
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Zip | 10004-2837
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Country | US
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Telephone | 212-477-3600
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Fax | 212-477-0795
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Authorized Official
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Title or Position | INTERIM CEO
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Name | MR. PAUL VITALE
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Credential |
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Telephone | 212-477-3600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 96251001
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License Number State | NY
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