Organization
NISKAYUNA OPERATING CO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATHEW VARGHESE MSN, GNP, LNHA (EXECUTIVE DIRECTOR)
(518) 374-2212
Entity
Organization
Contact information
Practice address
1805 PROVIDENCE AVE, NISKAYUNA, NY 12309-3923
(518) 374-2212
(518) 381-9068
Mailing address
1805 PROVIDENCE AVE, NISKAYUNA, NY 12309-3923
(518) 374-2212
(518) 381-9068
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
4652301N
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01122765
—
NY
Enumeration date
08/26/2010
Last updated
08/26/2010
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