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General NPI Number Information
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NPI Number | 1386774818
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Entity Type | Organization
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Legal Business Name | EGER HARBOR HOUSE
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 07/08/2015
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Provider Practice Location Address
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Address Line | 110 MEISNER AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10306-1236
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Country | US
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Telephone | 718-989-3017
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Fax | 718-980-3040
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Provider Business Mailing Address
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Address Line | 110 MEISNER AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10306-1236
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Country | US
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Telephone | 718-989-3017
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Fax | 718-980-3040
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. DENISE MORANO
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Credential |
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Telephone | 718-554-8701
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State | NY
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