MEDICARE: NORTHERN RIVERVIEW HEALTH CARE CENTER 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	4321302N	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	:	1295726552
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHERN RIVERVIEW HEALTH CARE CENTER INC

Provider Business Mailing Address
First Line	:	87 S ROUTE 9W
Second Line	:
City	:	HAVERSTRAW
State	:	NY
Zip	:	10927-1700
Country	:	US
Telephone Number	:	845-429-5381
Fax Number	:	845-429-3001

Provider Business Practice Location Address
First Line	:	87 S ROUTE 9W
Second Line	:
City	:	HAVERSTRAW
State	:	NY
Zip	:	10927-1700
Country	:	US
Telephone Number	:	845-429-5381
Fax Number	:	845-429-3001

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MS. KYLE OLOUGHLIN CAHILL
Credential	:
Telephone Number	:	845-429-5381

Provider Enumeration Date	:	11/03/2005
Last Update Date	:	02/11/2008

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