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NPI Code Detail

MEDICARE: MIDWAY NURSING HOME, INC.

MEDICARE: MIDWAY NURSING HOME, 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
1314000000XSkilled Nursing Facility

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1881622785
Entity Type Code : Organization
Provider Name (Legal Business Name) : MIDWAY NURSING HOME, INC.
Provider Business Mailing Address
First Line : 6995 QUEENS MIDTOWN EXPY
Second Line : EXPRESSWAY
City : MASPETH
State : NY
Zip : 11378-1922
Country : US
Telephone Number : 718-961-1212
Fax Number : 718-461-9484
Provider Business Practice Location Address
First Line : 6995 QUEENS MIDTOWN EXPY
Second Line : EXPRESSWAY
City : MASPETH
State : NY
Zip : 11378-1922
Country : US
Telephone Number : 718-961-1212
Fax Number : 718-461-9484
Authorized Official
Title or Position : PRESIDENT
Name : MR. MOSHE KALTER
Credential :
Telephone Number : 718-961-1212
Provider Enumeration Date : 06/29/2006
Last Update Date : 08/22/2020

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