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General NPI Number Information
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NPI Number | 1508400649
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Entity Type | Organization
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Legal Business Name | NEWCO ALP INC
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Dates
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Enumeration Date | 11/01/2019
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Last Update Date | 11/01/2019
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Provider Practice Location Address
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Address Line | 820 FRONT ST
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City | HEMPSTEAD
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State | NY
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Zip | 11550-4627
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Country | US
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Telephone | 516-708-0502
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Fax | 516-564-5353
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Provider Business Mailing Address
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Address Line | 820 FRONT ST
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City | HEMPSTEAD
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State | NY
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Zip | 11550-4627
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Country | US
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Telephone | 516-708-0502
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Fax | 516-564-5353
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Authorized Official
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Title or Position | CONTROLLER
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Name | MR. SHIA ROSENBAUM
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Credential |
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Telephone | 516-708-0507
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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 |
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