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General NPI Number Information
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NPI Number | 1427062488
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Entity Type | Organization
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Legal Business Name | UCP BAYVILLE INC.
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Dates
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Enumeration Date | 07/27/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 85 BAYVILLE AVE
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City | BAYVILLE
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State | NY
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Zip | 11709-1629
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Country | US
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Telephone | 516-628-3500
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Fax | 516-628-1121
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Provider Business Mailing Address
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Address Line | 85 BAYVILLE AVE
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City | BAYVILLE
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State | NY
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Zip | 11709-1629
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Country | US
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Telephone | 516-628-3500
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Fax | 516-628-1121
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. PAUL LOWRY
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Credential |
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Telephone | 516-628-3500
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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 | 8077440
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License Number State | NY
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