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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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