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NPI Code Detail

MEDICARE: PALISADE NURSING HOME CO INC.

MEDICARE: PALISADE NURSING HOME CO INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility7000347NNY

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
233-5629OTHERNYMEDICARE PROVIDER NUMBER

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1013026863
Entity Type Code : Organization
Provider Name (Legal Business Name) : PALISADE NURSING HOME CO INC.
Provider Business Mailing Address
First Line : 5901 PALISADE AVE
Second Line :
City : BRONX
State : NY
Zip : 10471-1205
Country : US
Telephone Number : 718-581-1310
Fax Number : 718-796-7534
Provider Business Practice Location Address
First Line : 5901 PALISADE AVE
Second Line :
City : BRONX
State : NY
Zip : 10471-1205
Country : US
Telephone Number : 718-581-1310
Fax Number : 718-796-7534
Authorized Official
Title or Position : VICE PRESIDENT, FINANCE
Name : CARL WILLNER
Credential :
Telephone Number : 718-581-1313
Provider Enumeration Date : 08/29/2006
Last Update Date : 08/26/2015

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Directions to “PALISADE NURSING HOME CO INC. ” Practice Location

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