Provider Demographics
NPI:1497791941
Name:UNITED HOME FOR AGED HEBREWS
Entity Type:Organization
Organization Name:UNITED HOME FOR AGED HEBREWS
Other - Org Name:UNITED HOME FOR AGED HEBREWS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:ISAAC
Authorized Official - Middle Name:
Authorized Official - Last Name:COHEN
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:914-632-8663
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:914-632-8663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-22
Last Update Date:2010-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NY0228383336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3335850OtherNCPDP PROVIDER IDENTIFICATION NUMBER
NY01765017Medicaid