Organization
MICHAEL TENENBAUM
Active
Other names
RESORT NURSING HOME
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB PERLES (ADMINISTRATOR)
(718) 474-5200
Entity
Organization
Contact information
Practice address
430 BEACH 68TH ST, ARVERNE, NY 11692-1407
(718) 474-5200
(718) 474-5214
Mailing address
430 BEACH 68TH ST, ARVERNE, NY 11692-1407
(718) 474-5200
(718) 474-5214
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
7003330N
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00310554
—
NY
01
—
1694
PFI
NY
01
—
7003330N
LICENSE
NY
Enumeration date
08/20/2006
Last updated
03/10/2021
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