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General NPI Number Information
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NPI Number | 1467471375
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Entity Type | Organization
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Legal Business Name | HYDE PARK NURSING HOME, INC.
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 08/17/2016
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Provider Practice Location Address
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Address Line | 4975 ALBANY POST ROAD
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City | STAATSBURG
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State | NY
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Zip | 12580
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Country | US
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Telephone | 845-889-4500
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Fax | 845-889-4309
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Provider Business Mailing Address
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Address Line | 4975 ALBANY POST ROAD
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City | STAATSBURG
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State | NY
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Zip | 12580
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Country | US
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Telephone | 845-889-4500
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Fax | 845-889-4309
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. RAPHAEL YENOWITZ
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Credential |
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Telephone | 845-889-4500
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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 | 1356302N
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License Number State | NY
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