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NPI Code Detail

MEDICARE: KATERI RESIDENCE

MEDICARE: KATERI RESIDENCE
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 Facility7002344NNY

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 : 1053316950
Entity Type Code : Organization
Provider Name (Legal Business Name) : KATERI RESIDENCE
Provider Business Mailing Address
First Line : 150 RIVERSIDE DR
Second Line :
City : NEW YORK
State : NY
Zip : 10024-2201
Country : US
Telephone Number : 646-505-3526
Fax Number : 212-595-9335
Provider Business Practice Location Address
First Line : 150 RIVERSIDE DR
Second Line :
City : NEW YORK
State : NY
Zip : 10024-2298
Country : US
Telephone Number : 646-505-3526
Fax Number : 212-595-9335
Authorized Official
Title or Position : CFO
Name : MRS. ANNMARIE COVONE
Credential :
Telephone Number : 646-633-4702
Provider Enumeration Date : 06/16/2005
Last Update Date : 12/15/2010

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Directions to “KATERI RESIDENCE ” Practice Location

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