Provider Demographics
NPI:1730258914
Name:WESTGATE NURSING HOME INC
Entity type:Organization
Organization Name:WESTGATE NURSING HOME INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:ROZENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-931-9700
Mailing Address - Street 1:4770 WHITE PLAINS RD
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10470-1104
Mailing Address - Country:US
Mailing Address - Phone:718-931-9700
Mailing Address - Fax:
Practice Address - Street 1:525 BEAHAN ROAD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14624
Practice Address - Country:US
Practice Address - Phone:585-247-7880
Practice Address - Fax:585-247-6323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2018-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2753301N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00355606Medicaid
335556Medicare ID - Type Unspecified