Provider Demographics
NPI:1467907584
Name:HEBREW HOME FOR HEALTH AND REHABILITATION LLC
Entity Type:Organization
Organization Name:HEBREW HOME FOR HEALTH AND REHABILITATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:BOKOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-705-4802
Mailing Address - Street 1:20 E SUNRISE HWY
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11581-1260
Mailing Address - Country:US
Mailing Address - Phone:516-705-4802
Mailing Address - Fax:
Practice Address - Street 1:1 ABRAHMS BLVD
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06117-1508
Practice Address - Country:US
Practice Address - Phone:860-523-3993
Practice Address - Fax:860-523-3816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-18
Last Update Date:2017-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT075109Medicare Oscar/Certification