Provider Demographics
NPI:1700884053
Name:KENDAL ON HUDSON
Entity Type:Organization
Organization Name:KENDAL ON HUDSON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:K
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-922-1082
Mailing Address - Street 1:1010 KENDAL WAY
Mailing Address - Street 2:KENDAL ON HUDSON
Mailing Address - City:SLEEPY HOLLOW
Mailing Address - State:NY
Mailing Address - Zip Code:10591
Mailing Address - Country:US
Mailing Address - Phone:914-922-1082
Mailing Address - Fax:914-922-1150
Practice Address - Street 1:1010 KENDAL WAY
Practice Address - Street 2:KENDAL ON HUDSON
Practice Address - City:SLEEPY HOLLOW
Practice Address - State:NY
Practice Address - Zip Code:10591
Practice Address - Country:US
Practice Address - Phone:914-922-1082
Practice Address - Fax:914-922-1150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-11
Last Update Date:2012-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY5932300NMedicaid
335848Medicare PIN
NY5932300NMedicaid