Provider Demographics
NPI:1275608390
Name:JEWISH HOME LIFECARE SARAH NEUMAN CENTER WESTCHESTER
Entity Type:Organization
Organization Name:JEWISH HOME LIFECARE SARAH NEUMAN CENTER WESTCHESTER
Other - Org Name:SARAH NEUMAN NURSING HOME - MEDICAL DEPT
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AUDREY
Authorized Official - Middle Name:
Authorized Official - Last Name:WEINER
Authorized Official - Suffix:
Authorized Official - Credentials:DSW
Authorized Official - Phone:212-870-4600
Mailing Address - Street 1:845 PALMER AVE
Mailing Address - Street 2:ATTN MEDICAL DEPARTMENT
Mailing Address - City:MAMARONECK
Mailing Address - State:NY
Mailing Address - Zip Code:10543-2406
Mailing Address - Country:US
Mailing Address - Phone:914-864-5856
Mailing Address - Fax:
Practice Address - Street 1:845 PALMER AVE
Practice Address - Street 2:ATTN MEDICAL DEPARTMENT
Practice Address - City:MAMARONECK
Practice Address - State:NY
Practice Address - Zip Code:10543-2406
Practice Address - Country:US
Practice Address - Phone:914-864-5856
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JEWISH HOME LIFCARE SARAH NEUMAN CENTER WESTCHESTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-22
Last Update Date:2018-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5909302N207RG0300X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW76851Medicare ID - Type Unspecified