Provider Demographics
NPI:1033236211
Name:AMSTERDAM NURSING HOME CORPORATION
Entity Type:Organization
Organization Name:AMSTERDAM NURSING HOME CORPORATION
Other - Org Name:AMSTERDAM NURSING HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT C.F.O.
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:PANCIRER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-734-6621
Mailing Address - Street 1:1060 AMSTERDAM AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-1715
Mailing Address - Country:US
Mailing Address - Phone:212-316-7700
Mailing Address - Fax:212-662-1793
Practice Address - Street 1:1060 AMSTERDAM AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-1715
Practice Address - Country:US
Practice Address - Phone:212-316-7700
Practice Address - Fax:212-662-1793
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00314594Medicaid
NYDTP01958263OtherSHP MNGD MCAD
NYA1011800OtherOXFORD PROVIDER NUMBER
NY335570OtherHIP PROVIDER NUMBER
NY7002356NMedicaid
NYDTP01958263Medicaid
NY007894OtherBCBS PROVIDER NUMBER
NY7100141OtherUNITED HEALTH CARE
NY01958263Medicaid
NY0803121OtherAETNA HMO PROVIDER NUMBER
NY7100141OtherEVERCARE PROVIDER NUMBER
NY133734710OtherELDERPLAN
NY5309499OtherAETNA PROVIDER NUMBER
NYDTP01958263OtherSHP MNGD MCAD
NY00314594Medicaid