MEDICARE: THROGS NECK 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
1	314000000X	Skilled Nursing Facility	7000386N	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	:	1568535284
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THROGS NECK OPERATING CO LLC

Provider Business Mailing Address
First Line	:	707 THROGGS NECK EXPY
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10465-2319
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	707 THROGGS NECK EXPY
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10465-2319
Country	:	US
Telephone Number	:	718-430-0003
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	BENT PHILIPSON
Credential	:
Telephone Number	:	516-869-3700

Provider Enumeration Date	:	11/17/2006
Last Update Date	:	08/22/2020

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