Organization
HOLLIS PARK MANOR NURSING HOME, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JONATHAN GEWIRTZ (MANAGER, FISCAL OVERSIGHT)
(914) 588-8379
Entity
Organization
Contact information
Practice address
19106 HILLSIDE AVE, HOLLIS, NY 11423-1942
(718) 479-1010
(718) 464-8245
Mailing address
19106 HILLSIDE AVE, HOLLIS, NY 11423-1942
(718) 479-1010
(718) 464-8245
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00310054
—
NY
Enumeration date
07/15/2005
Last updated
06/29/2015
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