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NPI Code Detail

MEDICARE: 150 RIVERSIDE OP. LLC

MEDICARE: 150 RIVERSIDE OP. 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 Facility

General Provider Information

NPI Number : 1558704544
Entity Type Code : Organization
Provider Name (Legal Business Name) : 150 RIVERSIDE OP. LLC
Provider Business Mailing Address
First Line : 150 RIVERSIDE DR
Second Line :
City : NEW YORK
State : NY
Zip : 10024-2298
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 150 RIVERSIDE DR
Second Line :
City : NEW YORK
State : NY
Zip : 10024-2298
Country : US
Telephone Number : 646-505-3500
Fax Number :
Authorized Official
Title or Position : CFO
Name : YOSSIE ZUCKER
Credential :
Telephone Number : 732-370-8090
Provider Enumeration Date : 04/09/2013
Last Update Date : 09/19/2014

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