MEDICARE: WINDSOR GARDENS CARE CENTER

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
1	314000000X	Skilled Nursing Facility	060722	NJ

Other Identifiers

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

General Provider Information

NPI Number	:	1053677534
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WINDSOR GARDENS CARE CENTER

Provider Business Mailing Address
First Line	:	140 PARK AVE
Second Line	:
City	:	EAST ORANGE
State	:	NJ
Zip	:	07017-5248
Country	:	US
Telephone Number	:	201-767-0100
Fax Number	:

Provider Business Practice Location Address
First Line	:	140 PARK AVE
Second Line	:
City	:	EAST ORANGE
State	:	NJ
Zip	:	07017-5248
Country	:	US
Telephone Number	:	201-767-0100
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	MR. EDWARD S NEUMANN
Credential	:
Telephone Number	:	201-767-0100

Provider Enumeration Date	:	04/09/2012
Last Update Date	:	04/09/2012

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