Organization
MENORAH HOME & HOSPITAL FOR THE AGED & INFIRM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID WAGNER (PRESIDENT & CEO)
(718) 491-7209
Entity
Organization
Contact information
Practice address
1516 ORIENTAL BLVD, BROOKLYN, NY 11235-2328
(718) 646-4441
Mailing address
1516 ORIENTAL BLVD, BROOKLYN, NY 11235-2328
(718) 646-4441
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
7001372N
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00708181
—
NY
01
—
007917
BC/BS PROVIDER #
NY
Enumeration date
06/24/2005
Last updated
03/16/2022
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