MEDICARE: TERRACE HEALTHCARE CENTER, INC.

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	7000378N	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1258	OTHER	NY	PFI
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1780681874
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TERRACE HEALTHCARE CENTER, INC.

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	:	718-601-5030

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	:	718-601-5030

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. LOWELL S. FELDMAN
Credential	:	LNHA
Telephone Number	:	718-796-5800

Provider Enumeration Date	:	07/05/2005
Last Update Date	:	08/22/2020

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