Organization
BAYBERRY NURSING HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LEONARD RUSS (ADMINISTRATOR)
(914) 636-6200
Entity
Organization
Contact information
Practice address
40 KEOGH LN, NEW ROCHELLE, NY 10805-1308
(914) 636-6200
(914) 636-5125
Mailing address
40 KEOGH LN, NEW ROCHELLE, NY 10805-1308
(914) 636-6200
(914) 636-5125
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
5904317N
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00420397
—
NY
Enumeration date
06/22/2005
Last updated
08/22/2020
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