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General NPI Number Information
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NPI Number | 1376989376
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Entity Type | Organization
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Legal Business Name | EXCEL AT WOODBURY FOR REHABILITATION AND NURSING LLC
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Dates
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Enumeration Date | 05/16/2013
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Last Update Date | 05/16/2013
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Provider Practice Location Address
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Address Line | 8533 JERICHO TPKE
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City | WOODBURY
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State | NY
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Zip | 11797-1804
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Country | US
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Telephone | 718-939-7500
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Fax | 718-559-4920
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Provider Business Mailing Address
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Address Line | 8533 JERICHO TPKE
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City | WOODBURY
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State | NY
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Zip | 11797-1804
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Country | US
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Telephone | 718-939-7500
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Fax | 718-559-4920
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Authorized Official
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Title or Position | ACCOUNTS RECEIVABLE BOOKKEEPER
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Name | LUCY MOSCHETTA
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Credential |
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Telephone | 718-939-7500
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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 | 2952303N
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License Number State | NY
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