MEDICARE: ASSISTED LIVING AT NORTHERN RIVERVIEW

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	310400000X	Assisted Living Facility	620E019	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	:	1396832721
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASSISTED LIVING AT NORTHERN RIVERVIEW

Provider Business Mailing Address
First Line	:	89 S ROUTE 9W
Second Line	:
City	:	HAVERSTRAW
State	:	NY
Zip	:	10927-1700
Country	:	US
Telephone Number	:	845-429-4300
Fax Number	:

Provider Business Practice Location Address
First Line	:	89 S ROUTE 9W
Second Line	:
City	:	HAVERSTRAW
State	:	NY
Zip	:	10927-1700
Country	:	US
Telephone Number	:	845-429-4300
Fax Number	:

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	SALMON KAPLAN
Credential	:
Telephone Number	:	845-356-9880

Provider Enumeration Date	:	10/06/2006
Last Update Date	:	08/22/2020

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Directions to “ASSISTED LIVING AT NORTHERN RIVERVIEW ” Practice Location

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