MEDICARE: TERRACE ACQUISITION II 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		NY

General Provider Information

NPI Number	:	1639623929
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TERRACE ACQUISITION II LLC

Provider Business Mailing Address
First Line	:	2678 KINGSBRIDGE TER
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10463-7471
Country	:	US
Telephone Number	:	718-796-5800
Fax Number	:

Provider Business Practice Location Address
First Line	:	2678 KINGSBRIDGE TER
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10463-7471
Country	:	US
Telephone Number	:	718-796-5800
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	PASQUALE DEBENEDICTIS
Credential	:
Telephone Number	:	516-422-7818

Provider Enumeration Date	:	08/04/2016
Last Update Date	:	02/02/2024

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