Organization
MONTGOMERY NURSING HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEREMY R MACK (PARTNER)
(845) 457-3155
Entity
Organization
Contact information
Practice address
2817 ALBANY POST RD, MONTGOMERY, NY 12549-2132
(845) 457-3155
Mailing address
2817 ALBANY POST RD, MONTGOMERY, NY 12549-2132
(845) 457-3155
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
3560301N
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00311486
—
NY
Enumeration date
12/29/2006
Last updated
08/22/2020
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