Provider Demographics
NPI:1770589251
Name:CHARLES T. SITRIN HEALTH CARE CENTER, INC
Entity type:Organization
Organization Name:CHARLES T. SITRIN HEALTH CARE CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTA
Authorized Official - Middle Name:L
Authorized Official - Last Name:SERAFIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-797-3114
Mailing Address - Street 1:2050 TILDEN AVE
Mailing Address - Street 2:PO BOX 1000
Mailing Address - City:NEW HARTFORD
Mailing Address - State:NY
Mailing Address - Zip Code:13413-3613
Mailing Address - Country:US
Mailing Address - Phone:315-797-3114
Mailing Address - Fax:315-624-0474
Practice Address - Street 1:2050 TILDEN AVE
Practice Address - Street 2:BOX 1000
Practice Address - City:NEW HARTFORD
Practice Address - State:NY
Practice Address - Zip Code:13413-3613
Practice Address - Country:US
Practice Address - Phone:315-797-3114
Practice Address - Fax:315-797-6955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01815443Medicaid
NY00313539Medicaid
NY00633550Medicaid
NY00313539Medicaid
NY01815443Medicaid