Organization
BRIODY HEALTH CARE FACILTIY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANN BRIODY PETOCK RN, MSN, LNH (ADMINISTRATOR/OWNER)
(716) 434-6361
Entity
Organization
Contact information
Practice address
909 LINCOLN AVE, LOCKPORT, NY 14094-6142
(716) 434-6361
(716) 434-6396
Mailing address
909 LINCOLN AVE, LOCKPORT, NY 14094-6142
(716) 434-6361
(716) 434-6396
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
3101300N
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000219000
BLUE CROSS
NY
01
—
00010070502
UNIVERA
NY
01
—
00011419701
UNIVERA
NY
01
—
000508042004
BLUE CROSS
NY
01
—
000624931001
BLUE CROSS
NY
01
—
000624932001
BLUE CROSS
NY
01
—
000626902001
BLUE CROSS
NY
01
—
000626997001
BLUE CROSS
NY
01
—
000640005006
BLUE CROSS
NY
01
—
000670038001
BLUE CROSS
NY
01
—
000670088001
BLUE CROSS
NY
05
—
00475443
—
NY
01
—
0109980
INDEPENDENT HEALTH
NY
01
—
080047479
PALMETTO GBA
NY
01
—
44
INDEPENDENT HEALTH
NY
01
—
80084A
UPSTATE MEDICARE PART B
NY
01
—
T5
INDEPENDENT HEALTH
NY
Enumeration date
10/11/2005
Last updated
09/09/2009
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