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NPI Code Detail

MEDICARE: MONTGOMERY OPERATING CO LLC

MEDICARE: MONTGOMERY OPERATING CO LLC
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 Facility3561302NNY

General Provider Information

NPI Number : 1336478775
Entity Type Code : Organization
Provider Name (Legal Business Name) : MONTGOMERY OPERATING CO LLC
Provider Business Mailing Address
First Line : 2817 ALBANY POST RD
Second Line :
City : MONTGOMERY
State : NY
Zip : 12549-2132
Country : US
Telephone Number : 845-451-3155
Fax Number : 845-457-9663
Provider Business Practice Location Address
First Line : 2817 ALBANY POST RD
Second Line :
City : MONTGOMERY
State : NY
Zip : 12549-2132
Country : US
Telephone Number : 845-451-3155
Fax Number : 845-457-9663
Authorized Official
Title or Position : MANAGING MEMBER
Name : DR. BARRY HOCHDORF
Credential : DDS
Telephone Number : 845-457-3155
Provider Enumeration Date : 12/14/2009
Last Update Date : 08/04/2010

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Directions to “MONTGOMERY OPERATING CO LLC ” Practice Location

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