Lakeside Nursing Home, Inc

NPI 1053535617 - Skilled Nursing Facility - 314000000X

NPI Details
NPI 1053535617
Enumeration Date 04/12/2007
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name PATRICK M PATRICK
Position ADMINISTRATOR
Phone (607) 273-8072
Fax (607) 273-0373
Practice Location
1229 TRUMANSBURG ROAD
ITHACA NY, 14850-1313, US
Phone (607) 273-8072
Fax (607) 273-0373
Business Location
1229 TRUMANSBURG RD
ITHACA NY, 14850-1313, US
Phone (607) 273-8072
Fax (607) 273-0373
Toxanomy
Taxonomy Code 314000000X
License State New York
License Number 5401307N
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According to our database, Lakeside Nursing Home, Inc NPI is 1053535617, taxonomy code is 314000000X and license number is 5401307N, license state is located at New York. Lakeside Nursing Home, Inc physically located at 1229 Trumansburg Road, Ithaca NY, 14850-1313. NPI Number 1033115704 has the healthcare provider type.

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1053535617 NPI number is provided on an as is basis without warranty of any kind. 1053535617 is maintained by the National Plan & Provider Enumeration System. The contents of Lakeside Nursing Home, Inc are for informational purposes only.