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General NPI Number Information
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NPI Number | 1457379018
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Entity Type | Organization
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Legal Business Name | BRIDGEWATER CENTER FOR REHABILITATION & NURSING LLC
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Dates
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Enumeration Date | 07/18/2006
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Last Update Date | 11/09/2015
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Provider Practice Location Address
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Address Line | 159-163 FRONT STREET
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City | BINGHAMTON
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State | NY
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Zip | 13905-3103
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Country | US
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Telephone | 607-722-7225
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Fax | 607-722-0061
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Provider Business Mailing Address
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Address Line | 1 HILLCREST CENTER DRIVE SUITE #325
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City | SPRING VALLEY
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State | NY
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Zip | 10977-3740
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Country | US
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Telephone | 845-371-8100
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Fax | 845-371-0010
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Authorized Official
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Title or Position | CFO
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Name | MR. JACK AUGENSTEIN
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Credential |
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Telephone | 845-371-8100
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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 | 0301308N
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State | NY
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