Provider Demographics
NPI:1851613145
Name:CIRCLE OF FRIENDS OF ROCKLAND
Entity Type:Organization
Organization Name:CIRCLE OF FRIENDS OF ROCKLAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:MARSHA
Authorized Official - Middle Name:
Authorized Official - Last Name:ERLIKH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-562-6201
Mailing Address - Street 1:19 ROBERT PITT DR
Mailing Address - Street 2:SUITE 106
Mailing Address - City:MONSEY
Mailing Address - State:NY
Mailing Address - Zip Code:10952-5308
Mailing Address - Country:US
Mailing Address - Phone:854-504-0740
Mailing Address - Fax:
Practice Address - Street 1:19 ROBERT PITT DR
Practice Address - Street 2:SUITE 106
Practice Address - City:MONSEY
Practice Address - State:NY
Practice Address - Zip Code:10952-5308
Practice Address - Country:US
Practice Address - Phone:854-504-0740
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-27
Last Update Date:2010-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY091125000039OtherFIDELIS CARE NEW YORK