MEDICARE: CATSKILL CROSSINGS 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

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	:	1649486507
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CATSKILL CROSSINGS LLC

Provider Business Mailing Address
First Line	:	154 JEFFERSON HEIGHTS
Second Line	:
City	:	CATSKILL
State	:	NY
Zip	:	12414-1215
Country	:	US
Telephone Number	:	518-943-5151
Fax Number	:

Provider Business Practice Location Address
First Line	:	154 JEFFERSON HEIGHTS
Second Line	:
City	:	CATSKILL
State	:	NY
Zip	:	12414-1215
Country	:	US
Telephone Number	:	518-943-5151
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	BARRY BOKOW
Credential	:
Telephone Number	:	516-705-4800

Provider Enumeration Date	:	05/15/2007
Last Update Date	:	09/24/2015

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