Organization
PALISADE NURSING HOME CO INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARL WILLNER (VICE PRESIDENT, FINANCE)
(718) 581-1313
Entity
Organization
Contact information
Practice address
5901 PALISADE AVE, BRONX, NY 10471-1205
(718) 581-1310
(718) 796-7534
Mailing address
5901 PALISADE AVE, BRONX, NY 10471-1205
(718) 581-1310
(718) 796-7534
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
7000347N
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00309164
—
NY
01
—
33-5629
MEDICARE PROVIDER NUMBER
NY
Enumeration date
08/29/2006
Last updated
08/26/2015
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