Provider Demographics
NPI:1780681874
Name:TERRACE HEALTHCARE CENTER, INC.
Entity Type:Organization
Organization Name:TERRACE HEALTHCARE CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LOWELL
Authorized Official - Middle Name:S
Authorized Official - Last Name:FELDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA
Authorized Official - Phone:718-796-5800
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:718-601-5030
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:718-601-5030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7000378N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1258OtherPFI
NY00308205Medicaid
NY335659Medicare ID - Type Unspecified