Provider Demographics
NPI:1972687655
Name:IROP LLC
Entity Type:Organization
Organization Name:IROP LLC
Other - Org Name:INDIAN RIVER REHABILITATION AND NURSING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:STERN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-942-1344
Mailing Address - Street 1:4770 WHITE PLAINS RD
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10470-1104
Mailing Address - Country:US
Mailing Address - Phone:718-931-9700
Mailing Address - Fax:
Practice Address - Street 1:17 MADISON ST
Practice Address - Street 2:
Practice Address - City:GRANVILLE
Practice Address - State:NY
Practice Address - Zip Code:12832-1221
Practice Address - Country:US
Practice Address - Phone:518-642-2710
Practice Address - Fax:518-642-1318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2017-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00308512Medicaid
NY00308512Medicaid