Provider Demographics
NPI:1184734220
Name:HOME FOR THE AGED OF THE LITTLE SISTERS OF THE POOR OF THE CITY OF NY
Entity type:Organization
Organization Name:HOME FOR THE AGED OF THE LITTLE SISTERS OF THE POOR OF THE CITY OF NY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SR GERTRUDE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAIORINO
Authorized Official - Suffix:
Authorized Official - Credentials:ADMINISTRATOR
Authorized Official - Phone:347-329-1800
Mailing Address - Street 1:2999 SCHURZ AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10465-3826
Mailing Address - Country:US
Mailing Address - Phone:347-329-1800
Mailing Address - Fax:347-329-1810
Practice Address - Street 1:2999 SCHURZ AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10465-3826
Practice Address - Country:US
Practice Address - Phone:347-329-1800
Practice Address - Fax:347-329-1810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2017-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7000313N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00311046Medicaid
NY335849Medicare Oscar/Certification
NY33-5849Medicare ID - Type UnspecifiedPROVIDER NUMBER