Provider Demographics
NPI:1831262856
Name:BISHOP HENRY B HUCLES EPISCOPAL NURSING HOME
Entity type:Organization
Organization Name:BISHOP HENRY B HUCLES EPISCOPAL NURSING HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATION
Authorized Official - Prefix:DR
Authorized Official - First Name:EDNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BARNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-221-2600
Mailing Address - Street 1:835 HERKIMER ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11233-3031
Mailing Address - Country:US
Mailing Address - Phone:718-221-2600
Mailing Address - Fax:718-221-2687
Practice Address - Street 1:835 HERKIMER ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11233-3031
Practice Address - Country:US
Practice Address - Phone:718-221-2600
Practice Address - Fax:718-221-2687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7001379N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00310967Medicaid
NY00310967Medicaid
NYB77663Medicare UPIN
NY335070Medicare Oscar/Certification
NYF24003Medicare UPIN
NYF39715Medicare UPIN
NYG89218Medicare UPIN
NYD79302Medicare UPIN