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General NPI Number Information
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NPI Number | 1639244742
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Entity Type | Organization
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Legal Business Name | JEWISH HOME LIFECARE, MANHATTAN
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Dates
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Enumeration Date | 11/22/2006
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Last Update Date | 03/02/2018
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Provider Practice Location Address
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Address Line | 120 W 106TH ST ATTN MEDICAL DEPT
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City | NEW YORK
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State | NY
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Zip | 10025-3712
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Country | US
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Telephone | 212-870-4868
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Fax |
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Provider Business Mailing Address
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Address Line | 120 W 106TH ST ATTN MEDICAL DEPT
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City | NEW YORK
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State | NY
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Zip | 10025-3712
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Country | US
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Telephone | 212-870-4868
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Fax |
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Authorized Official
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Title or Position | CHIEF COMPLIANCE OFFICER
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Name | DANA PENNY
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Credential |
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Telephone | 212-870-4752
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 7002340N
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 7002340N
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 7002340N
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License Number State | NY
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Taxonomy #5
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | 7002340N
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License Number State | NY
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