Provider Demographics
NPI:1639623929
Name:TERRACE ACQUISITION II LLC
Entity Type:Organization
Organization Name:TERRACE ACQUISITION II LLC
Other - Org Name:FORDHAM NURSING AND REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PASQUALE
Authorized Official - Middle Name:
Authorized Official - Last Name:DEBENEDICTIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-422-7818
Mailing Address - Street 1:2678 KINGSBRIDGE TER
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-7471
Mailing Address - Country:US
Mailing Address - Phone:718-796-5800
Mailing Address - Fax:
Practice Address - Street 1:2678 KINGSBRIDGE TER
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-7471
Practice Address - Country:US
Practice Address - Phone:718-796-5800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-04
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY335659Medicare Oscar/Certification
33-5659Medicare PIN