Provider Demographics
NPI:1083036586
Name:ARISTACARE AT MANCHESTER
Entity Type:Organization
Organization Name:ARISTACARE AT MANCHESTER
Other - Org Name:ARISTACARE AT MANCHESTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SIDNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-315-3400
Mailing Address - Street 1:51 CRAGWOOD RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SOUTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07080-2405
Mailing Address - Country:US
Mailing Address - Phone:908-315-3400
Mailing Address - Fax:908-325-1669
Practice Address - Street 1:1770 TOBIAS AVE
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NJ
Practice Address - Zip Code:08759-5803
Practice Address - Country:US
Practice Address - Phone:732-657-1800
Practice Address - Fax:732-657-6802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-17
Last Update Date:2014-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ15280Medicaid
NJ15280Medicaid