Provider Demographics
NPI:1720186703
Name:NEW YORK CONGREGATIONAL NURSING CENTER
Entity Type:Organization
Organization Name:NEW YORK CONGREGATIONAL NURSING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:
Authorized Official - First Name:CECELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZUCKERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-576-7101
Mailing Address - Street 1:135 LINDEN BLVD
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-3302
Mailing Address - Country:US
Mailing Address - Phone:718-576-7101
Mailing Address - Fax:718-284-0349
Practice Address - Street 1:135 LINDEN BLVD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-3302
Practice Address - Country:US
Practice Address - Phone:718-576-7101
Practice Address - Fax:718-284-0349
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02901540Medicaid
NY02901540Medicaid