Organization
IRVINGTON HEALTHCARE PROVIDERS LLC
Active
Other names
CHANCELLOR SPECIALTY CARE CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAM STERN (COMPTROLLER)
(718) 576-0400
Entity
Organization
Contact information
Practice address
155 40TH ST, IRVINGTON, NJ 07111-1184
(973) 371-7878
(973) 371-4081
Mailing address
170 53RD ST, 3RD FLOOR, BROOKLYN, NY 11232-4319
(718) 567-0400
(718) 567-0600
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
060736
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5057906
—
NJ
Enumeration date
06/11/2006
Last updated
08/22/2020
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