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General NPI Number Information
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NPI Number | 1790879146
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Entity Type | Organization
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Legal Business Name | METHODIST CHURCH HOME FOR THE AGED IN THE CITY OF NEW YORK
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 03/09/2022
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Provider Practice Location Address
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Address Line | 4499 MANHATTAN COLLEGE PARKWAY
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City | BRONX
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State | NY
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Zip | 10471
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Country | US
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Telephone | 718-548-5100
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Fax | 718-548-3147
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Provider Business Mailing Address
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Address Line | 4499 MANHATTAN COLLEGE PARKWAY
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City | BRONX
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State | NY
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Zip | 10471
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Country | US
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Telephone | 718-548-5100
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Fax | 718-548-3147
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. MARIA ELENA PEREZ
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Credential |
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Telephone | 718-548-5100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376G00000X
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Taxonomy Name | Nursing Home Administrator
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License Number | 04740
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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 |
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