Provider Demographics
NPI:1336478775
Name:MONTGOMERY OPERATING CO LLC
Entity Type:Organization
Organization Name:MONTGOMERY OPERATING CO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:HOCHDORF
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:845-457-3155
Mailing Address - Street 1:2817 ALBANY POST RD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:NY
Mailing Address - Zip Code:12549-2132
Mailing Address - Country:US
Mailing Address - Phone:845-451-3155
Mailing Address - Fax:845-457-9663
Practice Address - Street 1:2817 ALBANY POST RD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:NY
Practice Address - Zip Code:12549-2132
Practice Address - Country:US
Practice Address - Phone:845-451-3155
Practice Address - Fax:845-457-9663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-14
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3561302N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility