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General NPI Number Information
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NPI Number | 1851496749
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Entity Type | Organization
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Legal Business Name | NYMEDPUTNAM, INC.
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 03/28/2008
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Provider Practice Location Address
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Address Line | 46 MOUNT EBO RD N
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City | BREWSTER
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State | NY
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Zip | 10509-3600
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Country | US
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Telephone | 845-278-3636
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Fax | 845-278-5723
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Provider Business Mailing Address
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Address Line | 46 MOUNT EBO RD N
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City | BREWSTER
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State | NY
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Zip | 10509-3600
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Country | US
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Telephone | 845-278-3636
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Fax | 845-278-5723
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. LAURENCE LADUE
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Credential | LNHA
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Telephone | 845-278-3636
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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 | 3950301N
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License Number State | NY
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