MEDICARE: WINGATE OF ULSTER, 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
1	314000000X	Skilled Nursing Facility	314000000X	NY

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	:	1295722510
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WINGATE OF ULSTER, INC.

Provider Business Mailing Address
First Line	:	63 KENDRICK ST
Second Line	:
City	:	NEEDHAM
State	:	MA
Zip	:	02494-2708
Country	:	US
Telephone Number	:	781-708-9513
Fax Number	:	781-707-9599

Provider Business Practice Location Address
First Line	:	1 WINGATE WAY
Second Line	:
City	:	HIGHLAND
State	:	NY
Zip	:	12528-2143
Country	:	US
Telephone Number	:	845-691-6800
Fax Number	:	845-691-6880

Authorized Official
Title or Position	:	CFO
Name	:	MS. TAMILYN M. LEVIN
Credential	:	ESQ.
Telephone Number	:	781-707-9510

Provider Enumeration Date	:	10/03/2005
Last Update Date	:	10/05/2012

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