Organization
CCRN OPERATOR LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH ZUPNIK (MANAGING MEMBER)
(845) 704-8000
Entity
Organization
Contact information
Practice address
128 PHOENIX MILLS RD, COOPERSTOWN, NY 13326-5716
(607) 544-2600
Mailing address
128 PHOENIX MILLS RD, COOPERSTOWN, NY 13326-5716
(607) 544-2600
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
3824300N
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00356414
—
NY
Enumeration date
10/13/2014
Last updated
06/08/2015
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