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General NPI Number Information
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NPI Number | 1629003892
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Entity Type | Organization
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Legal Business Name | ISABELLA GERIATRIC CENTER
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 515 AUDUBON AVE ATTN: FINANCE
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City | NEW YORK
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State | NY
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Zip | 10040-3403
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Country | US
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Telephone | 212-342-9309
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Fax | 212-781-6303
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Provider Business Mailing Address
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Address Line | 515 AUDUBON AVE ATTN: FINANCE
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City | NEW YORK
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State | NY
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Zip | 10040-3403
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Country | US
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Telephone | 212-342-9309
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Fax | 212-781-6303
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Authorized Official
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Title or Position | PRESIDENT CEO
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Name | MR. MARK KATOR
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Credential |
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Telephone | 212-342-9300
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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 | 7002352N
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License Number State | NY
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