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General NPI Number Information
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NPI Number | 1417993387
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Entity Type | Organization
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Legal Business Name | REGO PARK N H LTD
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Dates
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Enumeration Date | 06/21/2006
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Last Update Date | 09/23/2014
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Provider Practice Location Address
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Address Line | 11126 CORONA AVE
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City | FLUSHING
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State | NY
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Zip | 11368-4027
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Country | US
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Telephone | 718-592-6400
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Fax | 718-592-1400
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Provider Business Mailing Address
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Address Line | 11126 CORONA AVE
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City | FLUSHING
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State | NY
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Zip | 11368-4027
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Country | US
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Telephone | 718-592-6400
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Fax | 718-592-1400
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. HERBERT TUCHMAN
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Credential |
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Telephone | 718-592-6400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | 7003392N
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License Number State | NY
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