Organization
VK NEWBURYPORT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BARRY BOKOW (VICE PRESIDENT)
(516) 705-4802
Entity
Organization
Contact information
Practice address
180 LOW ST, NEWBURYPORT, MA 01950-3519
(978) 465-5361
Mailing address
46 STAUDERMAN AVE, LYNBROOK, NY 11563-2524
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110095728A
—
MA
Enumeration date
02/20/2013
Last updated
05/02/2016
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