Provider Demographics
NPI:1033636782
Name:UNITED HOME FOR AGED HEBREWS UNITED HEBREW GERIATRIC CENTER
Entity Type:Organization
Organization Name:UNITED HOME FOR AGED HEBREWS UNITED HEBREW GERIATRIC CENTER
Other - Org Name:UNITED HEBREW GERIATRIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLANUEVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-632-2804
Mailing Address - Street 1:391 PELHAM RD
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10805-2225
Mailing Address - Country:US
Mailing Address - Phone:914-632-2804
Mailing Address - Fax:914-355-3905
Practice Address - Street 1:40 WILLOW DR
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10805-2352
Practice Address - Country:US
Practice Address - Phone:914-632-2804
Practice Address - Fax:914-355-3905
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNITED HOME FOR AGED HEBREWS UNITED HEBREW GERIATRIC CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-08-24
Last Update Date:2017-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5904309N261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY5904309NMedicaid