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NPI Code Detail

MEDICARE: JEWISH HOME LIFECARE HARRY AND JEANETTE WEINBERG CAMPUS BRONX

MEDICARE: JEWISH HOME LIFECARE HARRY AND JEANETTE WEINBERG CAMPUS BRONX
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
1208100000XPhysical Medicine & Rehabilitation Physician7000317NNY
22084P0800XPsychiatry Physician7000317NNY
3363L00000XNurse Practitioner7000317NNY
4207RG0300XGeriatric Medicine (Internal Medicine) Physician7000317NNY

General Provider Information

NPI Number : 1306911722
Entity Type Code : Organization
Provider Name (Legal Business Name) : JEWISH HOME LIFECARE HARRY AND JEANETTE WEINBERG CAMPUS BRONX
Provider Business Mailing Address
First Line : 100 W KINGSBRIDGE RD
Second Line : ATTN MEDICAL DEPT
City : BRONX
State : NY
Zip : 10468-3903
Country : US
Telephone Number : 718-410-1500
Fax Number :
Provider Business Practice Location Address
First Line : 100 W KINGSBRIDGE RD
Second Line : ATTN MEDICAL DEPT
City : BRONX
State : NY
Zip : 10468-3903
Country : US
Telephone Number : 718-410-1500
Fax Number :
Authorized Official
Title or Position : CEO
Name : AUDREY WEINER
Credential : DSW
Telephone Number : 212-870-4600
Provider Enumeration Date : 11/21/2006
Last Update Date : 04/16/2013

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1912072208 — JEWISH HOME LIFECARE HARRY AND JEANETTE WEINBERG CAMPUS BRONX
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Directions to “JEWISH HOME LIFECARE HARRY AND JEANETTE WEINBERG CAMPUS BRONX ” Practice Location

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