| NPI | 1568916906 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEEPESH PATEL President 845-473-8996 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: NY F340980-1) |
| Additional Taxonomies | 302F00000X Exclusive Provider Organization (Licence: NY F340980-1) |
| 305S00000X Point of Service (Licence: NY F340980-1) | |
| Enumeration Date | 2016-08-13 |
| Last Update Date | 2016-08-13 |