Provider Demographics
NPI:1457332348
Name:UNITED NURSING HOME FOR THE AGED
Entity Type:Organization
Organization Name:UNITED NURSING HOME FOR THE AGED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:RITA
Authorized Official - Middle Name:C
Authorized Official - Last Name:MABLI
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:10805-2335
Mailing Address - Country:US
Mailing Address - Phone:914-632-2804
Mailing Address - Fax:
Practice Address - Street 1:391 PELHAM RD
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10805-2335
Practice Address - Country:US
Practice Address - Phone:914-632-2804
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00311142Medicaid
NY335474Medicare ID - Type Unspecified