Provider Demographics
NPI:1578623179
Name:RIVERDALE CENTER FOR NURSING AND REHABILITATION, LLC
Entity Type:Organization
Organization Name:RIVERDALE CENTER FOR NURSING AND REHABILITATION, LLC
Other - Org Name:D/B/A HUDSON POINTE AT RIVERDALE CENTER FOR NURSING & REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSKOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-514-2000
Mailing Address - Street 1:3220 HENRY HUDSON PARKWAY
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-3211
Mailing Address - Country:US
Mailing Address - Phone:718-514-2000
Mailing Address - Fax:718-514-2035
Practice Address - Street 1:3220 HENRY HUDSON PARKWAY
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-3211
Practice Address - Country:US
Practice Address - Phone:718-514-2000
Practice Address - Fax:718-514-2035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2015-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7000325N314000000X
NY7000388N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00308443Medicaid
NY335187Medicare Oscar/Certification
NY335187Medicare UPIN