Organization
GRAND MANOR HEALTH RELATED FACILITY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARTIN LIEBMAN (OPERATOR)
(718) 518-8892
Entity
Organization
Contact information
Practice address
700 WHITE PLAINS RD, BRONX, NY 10473-2634
(718) 518-8892
(718) 931-5994
Mailing address
700 WHITE PLAINS RD, BRONX, NY 10473-2634
(718) 518-8892
(718) 931-5994
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
00358021
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00358021
—
NY
01
—
335744
MEDICARE
NY
Enumeration date
05/27/2005
Last updated
08/25/2015
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