Provider Demographics
NPI:1295395184
Name:LEROY OPERATING LLC
Entity type:Organization
Organization Name:LEROY OPERATING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGEMENT
Authorized Official - Prefix:
Authorized Official - First Name:YOSEF
Authorized Official - Middle Name:
Authorized Official - Last Name:GERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-737-0600
Mailing Address - Street 1:199 COMMUNITY DR
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-5502
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10 MUNSON ST
Practice Address - Street 2:
Practice Address - City:LE ROY
Practice Address - State:NY
Practice Address - Zip Code:14482-8933
Practice Address - Country:US
Practice Address - Phone:585-768-2561
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-13
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility