Provider Demographics
NPI:1952517815
Name:POUGHKEEPSIE CROSSINGS LLC
Entity Type:Organization
Organization Name:POUGHKEEPSIE CROSSINGS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:BOKOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-705-4800
Mailing Address - Street 1:100 FRANKLIN STREET
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601
Mailing Address - Country:US
Mailing Address - Phone:845-454-4100
Mailing Address - Fax:
Practice Address - Street 1:100 FRANKLIN STREET
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601
Practice Address - Country:US
Practice Address - Phone:845-454-4100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2015-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY312309Medicaid
NY335440Medicare Oscar/Certification