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General NPI Number Information
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NPI Number | 1982693263
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Entity Type | Organization
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Legal Business Name | BRIDGEVIEW NURSING HOME
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Dates
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Enumeration Date | 10/19/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 143-10 20TH AVE
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City | WHITESTONE
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State | NY
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Zip | 11357
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Country | US
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Telephone | 718-961-1212
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Fax | 718-461-7543
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Provider Business Mailing Address
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Address Line | 143-10 20TH AVE
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City | WHITESTONE
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State | NY
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Zip | 11357
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Country | US
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Telephone | 718-961-1212
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Fax | 718-461-7543
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Authorized Official
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Title or Position | BUSINESS OFFICE MANAGER
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Name | MR. STEVEN WEISS
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Credential |
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Telephone | 718-961-1212
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | 7003309N
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License Number State | NY
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